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December 3, 1982

Adrenal Corticosteroids in Erythema Multiforme-Reply

JAMA. 1982;248(21):2836. doi:10.1001/jama.1982.03330210027020

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In Reply.—  Dr Golden's letter reporting the prophylactic use of oral corticosteroids to diminish or abort episodes of erythema multiforme that occur after herpes simplex infection brings to mind problems that three of our patients experienced. Each of these patients had had episodes of erythema multiforme, requiring two to three weeks of high-dose prednisone therapy. As these patients were observed for several months, it became apparent that their episodes of both herpes simplex infection and subsequent erythema multiforme were becoming more frequent, and more prednisone was necessary to keep their conditions under control. Eventually, these patients needed regular prednisone every other day for the adequate suppression of their erythema multiforme. We believed that the regular use of prednisone had possibly made these patients more susceptible to the recurrence of herpes simplex infections and subsequent erythema multiforme. They were hospitalized while the prednisone dosage was slowly tapered, and, eventually, all patients