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November 1960

Erythema Multiforme Caused by Coxsackie B 5: A Possible Association with Epidemic Pustular Stomatitis of Children

Author Affiliations

Cambridge, Mass.

Mt. Auburn Hospital; Visiting Dermatologist Cambridge City Hospital; Assistant Physician in Dermatology, Mount Auburn Hospital and Assistant in Dermatology, Boston University School of Medicine Massachusetts Memorial Hospital.

Arch Dermatol. 1960;82(5):737-739. doi:10.1001/archderm.1960.01580050079010

In the summer of 1959 in the Boston area, there was an epidemic of a peculiar vesiculopustular stomatitis of children, involving the mouth, the anterior buccal mucosa, and the vermillion border of the lips.

Local pediatricians diagnosed these cases as "herpangina" or "herpes simplex stomatitis" since such cases were not uncommon in their summer practices in previous years. In this instance the peculiar clinical distribution and appearance of lesions suggested that this syndrome may have been caused by a completely different etiologic agent.

Cases exhibited unusual, whitish, flattened or conical, discrete, pustular lesions, quite dramatic in appearance on the vermillon borders of the lips. Pustular lesions and shallow ulcers involved the anterior half of the buccal cavity also, with occasional rare ulceration noted more posteriorly. Lesions were noted on the hard and soft palate but only rarely on the tongue. Regional adenopathy was present with slight tenderness on palpation.


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