Sir.—I read with interest the case report by Lascari et al that appeared in the August issue of the Journal (128:254, 1974). Although it was mentioned that erythema multiforme or its severe variant, Stevens-Johnson syndrome, may be associated with Mycoplasma infections, it is quite possible that the entire skin and mucous membrane eruption that the child manifested was all due to erythema multiforme. I believe that the term "varicella-like" is just another way of subclassifying erythema multiforme, which may be quite variable. A quite reliable differential point between erythema multiforme and varicella would be Tzank smear (Giemsa stain of vesicle base) or a skin biopsy. Varicella presents as an intraepidermal vesicle associated with multinucleated giant cells and intranuclear inclusions.1 On the other hand, the vesicles or bullae that are associated with erythema multiforme are subepidermal. I believe that it is more than academic to establish the correct diagnosis, since
LOCKSHIN NA. Varicella-Like Rash Associated With Mycoplasma Infection. Am J Dis Child. 1975;129(1):136–137. doi:10.1001/archpedi.1975.02120380104026
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