Erythema multiforme major after chemoradiotherapy on tongue cancer patient

Erythema multiforme (EM) is an immune-mediated epidermal reaction that develops in association with a variety of factors, including drugs and viral and bacterial infections. Cases with strong inflammation or blistering can develop into severe drug eruptions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). There are some reports of EM associated with anti-cancer agents, but no reports of EM associated with viral infection after concurrent chemoradiotherapy (CCRT). A 40-year-old man presented at the emergency outpatient department with neck swelling and redness, widespread limb dermatitis, and oral mucositis. He had undergone postoperative CCRT a month earlier for secondary cervical lymph node metastasis of tongue cancer. Our dermatologist performed a biopsy and a blood test and diagnosed EM major against the background of immunosuppression caused by the CCRT, most suspected cause was a virus infection. EM during the CCRT perioperative period should be recognized as an important adverse event in the course of malignant tumors and distinguished from severe drug eruption caused by anticancer drugs.