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She was subsequently seen for the rapid onset of lesions on the skin and mucosas&#46; She had not received other drugs and she did not report a history of herpes infection&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed intense stomatitis with confluent ulcers and scabs affecting all of the lips and the oral&#44; palatine&#44; and pharyngeal mucosas&#44; associated with bilateral conjunctival hyperemia with discharge&#46; Numerous irregular&#44; edematous erythematous plaques with central vesicles and an erythematous halo&#44; giving them the appearance of atypical target lesions&#44; were observed on the skin of the face&#44; trunk&#44; limbs&#44; perineum&#44; and genital mucosa &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The palms and soles were not affected&#46; No tonsillar exudate was observed and there were no palpable lymph nodes in the head and neck&#46; Auscultation of the chest revealed crepitations&#46; Abdominal examination was normal&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was admitted with a clinical suspicion of erythema multiforme major secondary to <span class="elsevierStyleItalic">M pneumoniae</span> infection&#46; Laboratory tests were as follows&#58; C-reactive protein&#44; 21<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; anti-streptolysin O titer&#44; 222<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#59; white cell count&#44; 22<span class="elsevierStyleHsp" style=""></span>850<span class="elsevierStyleHsp" style=""></span>cells&#47;&#956;L &#40;82&#46;3&#37; neutrophils&#44; with no atypical lymphocytes&#41;&#59; <span class="elsevierStyleItalic">M pneumoniae</span> IgM antibody&#44; 292<span class="elsevierStyleHsp" style=""></span>U&#59; herpes simplex virus&#44; Epstein-Barr virus&#44; and cytomegalovirus serology&#44; negative&#46; Chest x-ray showed a pneumonia infiltrate in the right upper lobe &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Skin biopsy revealed an intense vacuolar interface lesion&#44; isolated necrotic keratinocytes&#44; and extensive dermoepidermal separation&#44; with no epithelial necrosis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Treatment was started with intravenous methylprednisolone&#44; 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#44; clarithromycin&#44; and acyclovir&#46; The acyclovir was withdrawn after the serology results were received&#46; Topical corticosteroids and antibiotics were applied to the conjunctival and oral mucosas&#44; and fluid support and analgesia were administered until the patient&#39;s condition improved&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The skin lesions increased for a further 3 days&#44; affecting up to 20&#37; of the body surface&#44; and took on a crusted&#44; purpuric appearance&#44; with lesions simultaneously observed in distinct stages&#46; Some lesions developed flaccid blisters that did not coalesce or rupture&#46; The Nikolski sign was negative and exfoliation did not occur&#46; After 10 days the patient&#39;s condition had improved sufficiently for her to be discharged with only a residual hyperpigmentation&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">M pneumoniae</span> is implicated in up to 40&#37; of atypical pneumonias&#44; particularly in children and young adults&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> It provokes changes in the skin in up to a fourth of patients&#44; with nonspecific rash being most common&#44; though stomatitis&#44; vaginal ulcers&#44; pityriasis rosea&#44; Kawasaki disease&#44; leukocytoclastic vasculitis&#44; subcorneal pustular dermatosis&#44; Sweet syndrome&#44; thrombotic thrombocytopenic purpura&#44; Raynaud disease&#44; Henoch-Schonlein purpura&#44; and other conditions are also observed&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> The exact incidence of EM in children and young adults who develop infection due to <span class="elsevierStyleItalic">M pneumoniae</span> and other <span class="elsevierStyleItalic">Mycoplasma</span> species<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> is unknown&#44; while that of SJS has been estimated at approximately 5&#37;&#44; though these data may be affected by the confusing nomenclature&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">10&#44;11</span></a> Because of the clinical overlap between these syndromes&#44; EM&#44; SJS&#44; and TEN have for decades been considered part of a spectrum&#46; However&#44; the Severe Cutaneous Adverse Reactions study concluded that EM and SJS&#47;TEN can be separated into 2 distinct groups based on their clinical characteristics&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">5</span></a> A later multicenter study confirmed the validity of that classification and its correlation with etiologic and prognostic factors&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> and the 2 conditions are now considered separate entities&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a> It was difficult to confidently classify our patient into 1 of these groups&#44; because the infectious origin&#44; the acute onset&#44; the target morphology of the lesions&#44; and the favorable clinical course supported a diagnosis of EM&#44; while the general symptoms&#44; the central distribution with centripetal spread&#44; and the large area affected by the lesions&#44; together with intense involvement of 3 mucosas&#44; was consistent with SJS&#46; The differences between these conditions are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">In a study recently published by Canavan et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> the authors reviewed the epidemiological and clinical characteristics of the 202 published cases of mucocutaneous rash associated with <span class="elsevierStyleItalic">M pneumoniae</span>&#46; Their results&#44; which we summarize here&#44; led them to propose the creation of a new entity separate from the EM spectrum&#46; Their patients were young &#40;mean age&#44; 11&#46;9 years&#41;&#44; with prodromal symptoms consisting of cough&#44; malaise&#44; and fever the week prior to the skin rash&#46; The distribution of the lesions was acral in 46&#37;&#44; widespread in 31&#37;&#44; and on the trunk in 23&#37;&#59; lesion morphology was variable&#44; the most common forms being vesicles and blisters &#40;77&#37;&#41; and target lesions &#40;48&#37;&#41;&#46; Mucosal involvement was intense and was fundamental to the diagnosis&#46; Most common was oral mucositis&#44; which occurred in 94&#37; of cases&#44; followed by bilateral purulent conjunctivitis &#40;82&#37;&#41; and involvement of the urogenital mucosa &#40;63&#37;&#41;&#46; The mean number of mucosas affected was 2&#46;5&#46; The disease had a benign course in the majority of patients&#44; with complete recovery in 81&#37;&#46; Only 4&#37; of patients required management in an intensive care unit according to that review article&#44; and the estimated mortality was 3&#37;&#46; Patients were mainly treated with antibiotics &#40;80&#37;&#41; and systemic corticosteroids &#40;35&#37;&#41;&#59; a minority &#40;8&#37;&#41; received intravenous immunoglobulin&#46; Recurrence rates were not particularly high &#40;8&#37;&#41;&#46; Those authors concluded that the etiology&#44; lesion morphology&#44; and clinical course&#44; as well as the potentially distinct treatment of these patients&#44; justified the designation of a clinical entity distinct from classic herpes simplex virus-associated EM and from drug-induced SJS&#47;TEN&#46; They proposed the term <span class="elsevierStyleItalic">Mycoplasma-induced rash and mucositis</span> &#40;MIRM&#41;&#46; This new classification is particularly useful in cases of extensive mucositis due to <span class="elsevierStyleItalic">M pneumoniae</span> without skin rash &#40;<span class="elsevierStyleItalic">MIRM sine rash</span> for those authors&#41;&#44; which did not adapt to the previous classifications and which could be due to certain strains of <span class="elsevierStyleItalic">M pneumoniae</span>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The etiologic and pathogenic hypothesis is that MIRM is caused by the production of immunoglobulins by proliferating clones of B cells&#44; and that this leads to immune complex deposition in the skin and to the activation of complement&#46; This also differentiates the condition from EM and from SJS&#47;TEN&#44; which are caused by a type <span class="elsevierStyleSmallCaps">IV</span> delayed hypersensitivity reaction and by Fas-ligand-mediated cytotoxicity&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Our case is compatible with those described by Canavan et al&#46;&#44; and its classification within this new entity would dispel the diagnostic doubts that persisted after applying the criteria of the Severe Cutaneous Adverse Reactions study&#46; We would therefore favor accepting the proposal of those authors&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The classification of the severe mucocutaneous diseases secondary to infections and drugs is complex due to the clinical overlap between them&#46; After decades of controversy&#44; EM was separated from SJS&#47;TEN in 2002&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> Likewise&#44; in 2013&#44; drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41; was separated from the SJS spectrum&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> Acceptance of MIRM as an independent entity could facilitate correct diagnosis and more adequate treatment of our patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this research&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Confidentiality of data</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they followed their hospital&#39;s regulations regarding the publication of patient information&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data are disclosed in this article&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflicts of Interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "<span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Respiratory tract infection due to <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> can provoke cutaneous and mucosal rashes&#44; which have been classified within the spectrum of erythema multiforme or Stevens-Johnson syndrome&#46; This classification is of therapeutic and prognostic importance and has generated intense debate in the literature&#46; A recent systematic review of 202 cases of mucocutaneous rashes associated with <span class="elsevierStyleItalic">M&#46;&#160;pneumoniae</span> infection concluded that these rashes might constitute a distinct entity&#44; for which the term <span class="elsevierStyleItalic">Mycoplasma</span>-induced rash and mucositis was proposed&#46; We describe a patient with acute <span class="elsevierStyleItalic">M&#160;pneumoniae</span> respiratory tract infection who presented mucosal and cutaneous lesions that were difficult to classify as erythema multiforme or Stevens-Johnson syndrome&#59; the lesions were compatible with the proposed new disease&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La infecci&#243;n respiratoria por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> &#40;MP&#41; puede producir erupciones cut&#225;neo-mucosas que se han considerado parte del espectro eritema multiforme o del s&#237;ndrome de Stevens-Johnson&#46; La clasificaci&#243;n de estas reacciones cut&#225;neas&#44; que tiene importancia pron&#243;stica y terap&#233;utica&#44; ha generado mucha controversia en la literatura&#46; Recientemente&#44; una revisi&#243;n sistem&#225;tica de 202 casos de erupciones mucocut&#225;neas asociadas a infecci&#243;n por MP concluye que pueden constituir una entidad distinta para la que se propone la expresi&#243;n <span class="elsevierStyleItalic">Mycoplasma</span>-<span class="elsevierStyleItalic">induced rash and mucositis</span>&#46; Presentamos un caso de infecci&#243;n respiratoria aguda por MP con lesiones mucosas y cut&#225;neas dif&#237;ciles de clasificar como eritema multiforme o s&#237;ndrome de Stevens-Johnson&#44; y cuyas caracter&#237;sticas son compatibles con la nueva enfermedad propuesta&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Mart&#237;nez-P&#233;rez M&#44; Imbern&#243;n-Moya A&#44; Lobato-Berezo A&#44; Churruca-Grijelmo M&#46; Exantema mucocut&#225;neo inducido por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&#58; &#191;un nuevo s&#237;ndrome separado del eritema multiforme&#63; Un nuevo caso y revisi&#243;n de la literatura&#46; Actas Dermosifiliogr&#46; 2016&#59;107&#58;e47&#8211;e51&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A&#44; Bilateral conjunctival hyperemia with discharge&#46; B&#44; Irregular&#44; edematous erythematous papules with central vesicles and an erythematous halo&#44; forming palpable atypical target lesions&#44; widespread over the face&#44; trunk&#44; limbs&#44; and perineal and genital mucosas&#44; without affecting the palms and soles&#46; C&#44; Erosions&#44; confluent ulcers&#44; and scabs on the lips and mucosa&#46; D&#44; Changes in the skin lesions 2 days after onset of the rash&#46; E&#44; Detail of the atypical target lesions &#40;corresponds to the area of the star in image B&#41;&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pneumonia infiltrate in the right upper lobe &#40;arrow&#41;&#46;</p>"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Histopathology&#58; extensive vacuolar interface lesion&#44; isolated necrotic keratinocytes&#44; and extensive dermoepidermal separation with no epithelial necrosis&#46; Hematoxylin-eosin&#44; original magnification<span class="elsevierStyleHsp" style=""></span>x10&#46;</p>"
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; EM&#44; erythema multiforme&#59; HSV&#44; herpes simplex virus&#59; SJS&#44; Stevens-Johnson syndrome&#59; TEN&#44; toxic epidermal necrolysis&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Epidemiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Etiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Basic Lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Distribution&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prognosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">M pneumoniae</span>-induced rash and mucositis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mean age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 y<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a><br><br>Prodrome of respiratory tract infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">M pneumoniae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vesicles&#44; blisters&#44; mucositis &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>2 mucosas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Variable<br>Predominantly acral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Favorable<br><br>8&#37; recurrence rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macrolides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mean age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25 y<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a><br><br>History of HSV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#37; HSV<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> &#40;5&#37; drug-related&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Elevated typical&#47;atypical target lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Acral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Favorable&#44; 30&#37; recurrence rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Symptomatic<br><br>Consider HSV suppression&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Withdrawal of the causative drugs<br><br>Supportive measures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SJS&#47;TEN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10-30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TEN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;<span class="elsevierStyleHsp" style=""></span>30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Differences Between <span class="elsevierStyleItalic">Mycoplasma</span>-Induced Rash and Mucositis&#44; Erythema Multiforme&#44; and Stevens-Johnson Syndrome&#47;Toxic Epidermal Necrolysis Spectrum&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae infection associated with bullous erythema multiforme"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;C&#46; Schalock"
                            1 => "J&#46;B&#46; Brennick"
                            2 => "J&#46;G&#46; Dinulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2004.11.074"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2005"
                        "volumen" => "52"
                        "paginaInicial" => "705"
                        "paginaFinal" => "706"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15793531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent erythema multiforme in association with recurrent <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Grosber"
                            1 => "M&#46; Alexandre"
                            2 => "E&#46; Poszepczynska-Guigne"
                            3 => "J&#46; Revuz"
                            4 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.05.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "S118"
                        "paginaFinal" => "S119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17434037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome&#44; not erythema multiforme &#40;von Hebra&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;K&#46; Tay"
                            1 => "J&#46;C&#46; Huff"
                            2 => "W&#46;L&#46; Weston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAAD"
                        "fecha" => "1996"
                        "volumen" => "35"
                        "paginaInicial" => "757"
                        "paginaFinal" => "760"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8912572"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is going on in erythema multiforme&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "1994"
                        "volumen" => "188"
                        "paginaInicial" => "249"
                        "paginaFinal" => "250"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8193394"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283809008604"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical classification of cases of toxic epidermal necrolysis&#44; Stevens-Johnson syndrome and erythema multiforme"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Bastuji-Garin"
                            1 => "B&#46; Rzany"
                            2 => "R&#46;S&#46; Stern"
                            3 => "N&#46;H&#46; Shear"
                            4 => "L&#46; Naldi"
                            5 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1993"
                        "volumen" => "129"
                        "paginaInicial" => "92"
                        "paginaFinal" => "96"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8420497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis&#58; A clinical classification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Investigative Dermat"
                        "fecha" => "1994"
                        "volumen" => "102"
                        "paginaInicial" => "28"
                        "paginaFinal" => "30"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythema multiforme with mucous membrane involvement and Stevens-Johnson syndrome are clinically different disorders with distinct causes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Assier"
                            1 => "S&#46; Bastuji-garin"
                            2 => "J&#46; Revuz"
                            3 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1995"
                        "volumen" => "131"
                        "paginaInicial" => "539"
                        "paginaFinal" => "543"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7741539"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlations between clinical patterns and causes of erythema multiforme majus&#44; Stevens-Johnson syndrome and toxic epidermal necrolysis&#58; Results of an international prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Auquier&#95;Dunant"
                            1 => "M&#46; Mockenhaupt"
                            2 => "L&#46; Naldi"
                            3 => "O&#46; Correia"
                            4 => "W&#46; Schr&#246;der"
                            5 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2002"
                        "volumen" => "138"
                        "paginaInicial" => "1019"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12164739"
                            "web" => "Medline"
                          ]
                        ]
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                          "pii" => "S0022534710042783"
                          "estado" => "S300"
                          "issn" => "00225347"
                        ]
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                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome de Stevens-Johnson y necr&#243;lisis epid&#233;rmica t&#243;xica&#58; experiencia cl&#237;nica y revisi&#243;n de la literatura especializada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Laguna"
                            1 => "B&#46; Mart&#237;n"
                            2 => "A&#46; Torrijos"
                            3 => "M&#46;L&#46; Garc&#237;a-Melgares"
                            4 => "I&#46; Febrer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "177"
                        "paginaFinal" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16796964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis&#44; classification and management of erythema multiforme and Stevens-Johnson syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Leaut&#233;-Labreze"
                            1 => "T&#46; Lamireau"
                            2 => "D&#46; Chawki"
                            3 => "J&#46; Maleville"
                            4 => "A&#46; Ta&#239;eb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2000"
                        "volumen" => "83"
                        "paginaInicial" => "347"
                        "paginaFinal" => "352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10999875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythema multiforme due to Mycoplasma pneumoniae infection in two children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;C&#46; Schalock"
                            1 => "J&#46;G&#46;H&#46; Dinulos"
                            2 => "N&#46; Pace"
                            3 => "K&#46; Schwarzenberger"
                            4 => "J&#46;K&#46; Wenger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1525-1470.2006.00307.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "23"
                        "paginaInicial" => "546"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17155996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae-induced rash and mucositis as a syndrome distinct from Stevens-Johnson syndrome and erythema multiforme&#46; A systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;N&#46; Canavan"
                            1 => "E&#46;F&#46; Mathes"
                            2 => "I&#46; Frieden"
                            3 => "K&#46; Shinkai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2014.06.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2015"
                        "volumen" => "72"
                        "paginaInicial" => "239"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25592340"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exudado uretral y afectaci&#243;n mucocut&#225;nea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Toledo-Pastrana"
                            1 => "A&#46; Zapata-L&#243;pez"
                            2 => "A&#46; Mich&#225;n-Do&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2014.04.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2014"
                        "volumen" => "214"
                        "paginaInicial" => "e91"
                        "paginaFinal" => "e92"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24889773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41;&#58; An original multisystem adverse drug reaction&#59; results from the prospective RegiSCAR study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;H&#46; Kardaun"
                            1 => "P&#46; Sekula"
                            2 => "L&#46; Valeyrie-Allanore"
                            3 => "Y&#46; Liss"
                            4 => "C&#46;Y&#46; Chu"
                            5 => "D&#46; Creamer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.12501"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "169"
                        "paginaInicial" => "1071"
                        "paginaFinal" => "1080"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23855313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
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        "identificador" => "xack277918"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0080" class="elsevierStylePara elsevierViewall">We would like to thank Dr&#46; Paola Bar&#243;n Rodiz&#44; of the radiology department of our hospital&#44; for her collaboration&#46;</p>"
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Mycoplasma pneumoniae-Induced Mucocutaneous Rash: A New Syndrome Distinct from Erythema Multiforme? Report of a New Case and Review of the Literature
Exantema mucocutáneo inducido por Mycoplasma pneumoniae: ¿un nuevo síndrome separado del eritema multiforme? Un nuevo caso y revisión de la literatura
M. Martínez-Pérez
Autor para correspondencia
mrcl_mtnez@yahoo.es

Corresponding author.
, A. Imbernón-Moya, A. Lobato-Berezo, M. Churruca-Grijelmo
Servicio de Dermatología y Venereología, Hospital Severo Ochoa, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infection affects the skin and mucosas in up to 25&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> and can cause erythema multiforme &#40;EM&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> and Stevens-Johnson syndrome&#47;toxic epidermal necrolysis &#40;SJS&#47;TEN&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a> The clinical overlap between these conditions&#44; which has led to long-standing debate in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">4&#8211;9</span></a> makes diagnosis difficult in some cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">10&#44;11</span></a> An extensive review of 202 cases of <span class="elsevierStyleItalic">M&#160;pneumoniae</span>-induced EM&#44; SJS&#44; and mucositis without rash was published recently&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> In their conclusions&#44; the authors proposed a new entity which they called <span class="elsevierStyleItalic">Mycoplasma-induced rash and mucositis</span>&#46; We present a case that we found difficult to classify and that was consistent with the new entity described&#46; As suggested by those authors&#44; we believe this entity could be helpful in the diagnosis and treatment of these cases in daily practice&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case Description</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient&#44; a previously healthy 16-year-old girl&#44; presented a 7-day history of fever of 38&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; odynophagia&#44; cough&#44; and wheeze&#46; She was diagnosed with acute bronchitis and received treatment with inhaled budesonide and ibuprofen&#46; She was subsequently seen for the rapid onset of lesions on the skin and mucosas&#46; She had not received other drugs and she did not report a history of herpes infection&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed intense stomatitis with confluent ulcers and scabs affecting all of the lips and the oral&#44; palatine&#44; and pharyngeal mucosas&#44; associated with bilateral conjunctival hyperemia with discharge&#46; Numerous irregular&#44; edematous erythematous plaques with central vesicles and an erythematous halo&#44; giving them the appearance of atypical target lesions&#44; were observed on the skin of the face&#44; trunk&#44; limbs&#44; perineum&#44; and genital mucosa &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The palms and soles were not affected&#46; No tonsillar exudate was observed and there were no palpable lymph nodes in the head and neck&#46; Auscultation of the chest revealed crepitations&#46; Abdominal examination was normal&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was admitted with a clinical suspicion of erythema multiforme major secondary to <span class="elsevierStyleItalic">M pneumoniae</span> infection&#46; Laboratory tests were as follows&#58; C-reactive protein&#44; 21<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; anti-streptolysin O titer&#44; 222<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#59; white cell count&#44; 22<span class="elsevierStyleHsp" style=""></span>850<span class="elsevierStyleHsp" style=""></span>cells&#47;&#956;L &#40;82&#46;3&#37; neutrophils&#44; with no atypical lymphocytes&#41;&#59; <span class="elsevierStyleItalic">M pneumoniae</span> IgM antibody&#44; 292<span class="elsevierStyleHsp" style=""></span>U&#59; herpes simplex virus&#44; Epstein-Barr virus&#44; and cytomegalovirus serology&#44; negative&#46; Chest x-ray showed a pneumonia infiltrate in the right upper lobe &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Skin biopsy revealed an intense vacuolar interface lesion&#44; isolated necrotic keratinocytes&#44; and extensive dermoepidermal separation&#44; with no epithelial necrosis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Treatment was started with intravenous methylprednisolone&#44; 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#44; clarithromycin&#44; and acyclovir&#46; The acyclovir was withdrawn after the serology results were received&#46; Topical corticosteroids and antibiotics were applied to the conjunctival and oral mucosas&#44; and fluid support and analgesia were administered until the patient&#39;s condition improved&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The skin lesions increased for a further 3 days&#44; affecting up to 20&#37; of the body surface&#44; and took on a crusted&#44; purpuric appearance&#44; with lesions simultaneously observed in distinct stages&#46; Some lesions developed flaccid blisters that did not coalesce or rupture&#46; The Nikolski sign was negative and exfoliation did not occur&#46; After 10 days the patient&#39;s condition had improved sufficiently for her to be discharged with only a residual hyperpigmentation&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">M pneumoniae</span> is implicated in up to 40&#37; of atypical pneumonias&#44; particularly in children and young adults&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> It provokes changes in the skin in up to a fourth of patients&#44; with nonspecific rash being most common&#44; though stomatitis&#44; vaginal ulcers&#44; pityriasis rosea&#44; Kawasaki disease&#44; leukocytoclastic vasculitis&#44; subcorneal pustular dermatosis&#44; Sweet syndrome&#44; thrombotic thrombocytopenic purpura&#44; Raynaud disease&#44; Henoch-Schonlein purpura&#44; and other conditions are also observed&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> The exact incidence of EM in children and young adults who develop infection due to <span class="elsevierStyleItalic">M pneumoniae</span> and other <span class="elsevierStyleItalic">Mycoplasma</span> species<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> is unknown&#44; while that of SJS has been estimated at approximately 5&#37;&#44; though these data may be affected by the confusing nomenclature&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">10&#44;11</span></a> Because of the clinical overlap between these syndromes&#44; EM&#44; SJS&#44; and TEN have for decades been considered part of a spectrum&#46; However&#44; the Severe Cutaneous Adverse Reactions study concluded that EM and SJS&#47;TEN can be separated into 2 distinct groups based on their clinical characteristics&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">5</span></a> A later multicenter study confirmed the validity of that classification and its correlation with etiologic and prognostic factors&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> and the 2 conditions are now considered separate entities&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a> It was difficult to confidently classify our patient into 1 of these groups&#44; because the infectious origin&#44; the acute onset&#44; the target morphology of the lesions&#44; and the favorable clinical course supported a diagnosis of EM&#44; while the general symptoms&#44; the central distribution with centripetal spread&#44; and the large area affected by the lesions&#44; together with intense involvement of 3 mucosas&#44; was consistent with SJS&#46; The differences between these conditions are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">In a study recently published by Canavan et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> the authors reviewed the epidemiological and clinical characteristics of the 202 published cases of mucocutaneous rash associated with <span class="elsevierStyleItalic">M pneumoniae</span>&#46; Their results&#44; which we summarize here&#44; led them to propose the creation of a new entity separate from the EM spectrum&#46; Their patients were young &#40;mean age&#44; 11&#46;9 years&#41;&#44; with prodromal symptoms consisting of cough&#44; malaise&#44; and fever the week prior to the skin rash&#46; The distribution of the lesions was acral in 46&#37;&#44; widespread in 31&#37;&#44; and on the trunk in 23&#37;&#59; lesion morphology was variable&#44; the most common forms being vesicles and blisters &#40;77&#37;&#41; and target lesions &#40;48&#37;&#41;&#46; Mucosal involvement was intense and was fundamental to the diagnosis&#46; Most common was oral mucositis&#44; which occurred in 94&#37; of cases&#44; followed by bilateral purulent conjunctivitis &#40;82&#37;&#41; and involvement of the urogenital mucosa &#40;63&#37;&#41;&#46; The mean number of mucosas affected was 2&#46;5&#46; The disease had a benign course in the majority of patients&#44; with complete recovery in 81&#37;&#46; Only 4&#37; of patients required management in an intensive care unit according to that review article&#44; and the estimated mortality was 3&#37;&#46; Patients were mainly treated with antibiotics &#40;80&#37;&#41; and systemic corticosteroids &#40;35&#37;&#41;&#59; a minority &#40;8&#37;&#41; received intravenous immunoglobulin&#46; Recurrence rates were not particularly high &#40;8&#37;&#41;&#46; Those authors concluded that the etiology&#44; lesion morphology&#44; and clinical course&#44; as well as the potentially distinct treatment of these patients&#44; justified the designation of a clinical entity distinct from classic herpes simplex virus-associated EM and from drug-induced SJS&#47;TEN&#46; They proposed the term <span class="elsevierStyleItalic">Mycoplasma-induced rash and mucositis</span> &#40;MIRM&#41;&#46; This new classification is particularly useful in cases of extensive mucositis due to <span class="elsevierStyleItalic">M pneumoniae</span> without skin rash &#40;<span class="elsevierStyleItalic">MIRM sine rash</span> for those authors&#41;&#44; which did not adapt to the previous classifications and which could be due to certain strains of <span class="elsevierStyleItalic">M pneumoniae</span>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The etiologic and pathogenic hypothesis is that MIRM is caused by the production of immunoglobulins by proliferating clones of B cells&#44; and that this leads to immune complex deposition in the skin and to the activation of complement&#46; This also differentiates the condition from EM and from SJS&#47;TEN&#44; which are caused by a type <span class="elsevierStyleSmallCaps">IV</span> delayed hypersensitivity reaction and by Fas-ligand-mediated cytotoxicity&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Our case is compatible with those described by Canavan et al&#46;&#44; and its classification within this new entity would dispel the diagnostic doubts that persisted after applying the criteria of the Severe Cutaneous Adverse Reactions study&#46; We would therefore favor accepting the proposal of those authors&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The classification of the severe mucocutaneous diseases secondary to infections and drugs is complex due to the clinical overlap between them&#46; After decades of controversy&#44; EM was separated from SJS&#47;TEN in 2002&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> Likewise&#44; in 2013&#44; drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41; was separated from the SJS spectrum&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> Acceptance of MIRM as an independent entity could facilitate correct diagnosis and more adequate treatment of our patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this research&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Confidentiality of data</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they followed their hospital&#39;s regulations regarding the publication of patient information&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data are disclosed in this article&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflicts of Interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "<span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Respiratory tract infection due to <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> can provoke cutaneous and mucosal rashes&#44; which have been classified within the spectrum of erythema multiforme or Stevens-Johnson syndrome&#46; This classification is of therapeutic and prognostic importance and has generated intense debate in the literature&#46; A recent systematic review of 202 cases of mucocutaneous rashes associated with <span class="elsevierStyleItalic">M&#46;&#160;pneumoniae</span> infection concluded that these rashes might constitute a distinct entity&#44; for which the term <span class="elsevierStyleItalic">Mycoplasma</span>-induced rash and mucositis was proposed&#46; We describe a patient with acute <span class="elsevierStyleItalic">M&#160;pneumoniae</span> respiratory tract infection who presented mucosal and cutaneous lesions that were difficult to classify as erythema multiforme or Stevens-Johnson syndrome&#59; the lesions were compatible with the proposed new disease&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La infecci&#243;n respiratoria por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> &#40;MP&#41; puede producir erupciones cut&#225;neo-mucosas que se han considerado parte del espectro eritema multiforme o del s&#237;ndrome de Stevens-Johnson&#46; La clasificaci&#243;n de estas reacciones cut&#225;neas&#44; que tiene importancia pron&#243;stica y terap&#233;utica&#44; ha generado mucha controversia en la literatura&#46; Recientemente&#44; una revisi&#243;n sistem&#225;tica de 202 casos de erupciones mucocut&#225;neas asociadas a infecci&#243;n por MP concluye que pueden constituir una entidad distinta para la que se propone la expresi&#243;n <span class="elsevierStyleItalic">Mycoplasma</span>-<span class="elsevierStyleItalic">induced rash and mucositis</span>&#46; Presentamos un caso de infecci&#243;n respiratoria aguda por MP con lesiones mucosas y cut&#225;neas dif&#237;ciles de clasificar como eritema multiforme o s&#237;ndrome de Stevens-Johnson&#44; y cuyas caracter&#237;sticas son compatibles con la nueva enfermedad propuesta&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Mart&#237;nez-P&#233;rez M&#44; Imbern&#243;n-Moya A&#44; Lobato-Berezo A&#44; Churruca-Grijelmo M&#46; Exantema mucocut&#225;neo inducido por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&#58; &#191;un nuevo s&#237;ndrome separado del eritema multiforme&#63; Un nuevo caso y revisi&#243;n de la literatura&#46; Actas Dermosifiliogr&#46; 2016&#59;107&#58;e47&#8211;e51&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A&#44; Bilateral conjunctival hyperemia with discharge&#46; B&#44; Irregular&#44; edematous erythematous papules with central vesicles and an erythematous halo&#44; forming palpable atypical target lesions&#44; widespread over the face&#44; trunk&#44; limbs&#44; and perineal and genital mucosas&#44; without affecting the palms and soles&#46; C&#44; Erosions&#44; confluent ulcers&#44; and scabs on the lips and mucosa&#46; D&#44; Changes in the skin lesions 2 days after onset of the rash&#46; E&#44; Detail of the atypical target lesions &#40;corresponds to the area of the star in image B&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; EM&#44; erythema multiforme&#59; HSV&#44; herpes simplex virus&#59; SJS&#44; Stevens-Johnson syndrome&#59; TEN&#44; toxic epidermal necrolysis&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Epidemiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Etiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Basic Lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Distribution&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Extension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prognosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">M pneumoniae</span>-induced rash and mucositis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mean age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 y<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a><br><br>Prodrome of respiratory tract infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">M pneumoniae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vesicles&#44; blisters&#44; mucositis &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>2 mucosas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Variable<br>Predominantly acral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Favorable<br><br>8&#37; recurrence rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Macrolides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mean age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25 y<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a><br><br>History of HSV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#37; HSV<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> &#40;5&#37; drug-related&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Elevated typical&#47;atypical target lesions&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Favorable&#44; 30&#37; recurrence rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Symptomatic<br><br>Consider HSV suppression&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Mean age<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45 y<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a><br><br>Drug exposure</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">45&#37; drug-related<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a><br><br>Other diseases &#40;collagen disease&#44; HIV&#44; tumors&#44; 15&#37; HSV&#41;</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Flat atypical target lesions<br><br>Blisters arising on macules and patches</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Trunk</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Withdrawal of the causative drugs<br><br>Supportive measures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SJS&#47;TEN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10-30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TEN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;<span class="elsevierStyleHsp" style=""></span>30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#37;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae infection associated with bullous erythema multiforme"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;C&#46; Schalock"
                            1 => "J&#46;B&#46; Brennick"
                            2 => "J&#46;G&#46; Dinulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2004.11.074"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2005"
                        "volumen" => "52"
                        "paginaInicial" => "705"
                        "paginaFinal" => "706"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15793531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent erythema multiforme in association with recurrent <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Grosber"
                            1 => "M&#46; Alexandre"
                            2 => "E&#46; Poszepczynska-Guigne"
                            3 => "J&#46; Revuz"
                            4 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.05.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "S118"
                        "paginaFinal" => "S119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17434037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome&#44; not erythema multiforme &#40;von Hebra&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;K&#46; Tay"
                            1 => "J&#46;C&#46; Huff"
                            2 => "W&#46;L&#46; Weston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAAD"
                        "fecha" => "1996"
                        "volumen" => "35"
                        "paginaInicial" => "757"
                        "paginaFinal" => "760"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8912572"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is going on in erythema multiforme&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "1994"
                        "volumen" => "188"
                        "paginaInicial" => "249"
                        "paginaFinal" => "250"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8193394"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283809008604"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical classification of cases of toxic epidermal necrolysis&#44; Stevens-Johnson syndrome and erythema multiforme"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Bastuji-Garin"
                            1 => "B&#46; Rzany"
                            2 => "R&#46;S&#46; Stern"
                            3 => "N&#46;H&#46; Shear"
                            4 => "L&#46; Naldi"
                            5 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1993"
                        "volumen" => "129"
                        "paginaInicial" => "92"
                        "paginaFinal" => "96"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8420497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis&#58; A clinical classification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Investigative Dermat"
                        "fecha" => "1994"
                        "volumen" => "102"
                        "paginaInicial" => "28"
                        "paginaFinal" => "30"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythema multiforme with mucous membrane involvement and Stevens-Johnson syndrome are clinically different disorders with distinct causes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Assier"
                            1 => "S&#46; Bastuji-garin"
                            2 => "J&#46; Revuz"
                            3 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1995"
                        "volumen" => "131"
                        "paginaInicial" => "539"
                        "paginaFinal" => "543"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7741539"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlations between clinical patterns and causes of erythema multiforme majus&#44; Stevens-Johnson syndrome and toxic epidermal necrolysis&#58; Results of an international prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Auquier&#95;Dunant"
                            1 => "M&#46; Mockenhaupt"
                            2 => "L&#46; Naldi"
                            3 => "O&#46; Correia"
                            4 => "W&#46; Schr&#246;der"
                            5 => "J&#46;C&#46; Roujeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2002"
                        "volumen" => "138"
                        "paginaInicial" => "1019"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12164739"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022534710042783"
                          "estado" => "S300"
                          "issn" => "00225347"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S&#237;ndrome de Stevens-Johnson y necr&#243;lisis epid&#233;rmica t&#243;xica&#58; experiencia cl&#237;nica y revisi&#243;n de la literatura especializada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Laguna"
                            1 => "B&#46; Mart&#237;n"
                            2 => "A&#46; Torrijos"
                            3 => "M&#46;L&#46; Garc&#237;a-Melgares"
                            4 => "I&#46; Febrer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "177"
                        "paginaFinal" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16796964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis&#44; classification and management of erythema multiforme and Stevens-Johnson syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Leaut&#233;-Labreze"
                            1 => "T&#46; Lamireau"
                            2 => "D&#46; Chawki"
                            3 => "J&#46; Maleville"
                            4 => "A&#46; Ta&#239;eb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2000"
                        "volumen" => "83"
                        "paginaInicial" => "347"
                        "paginaFinal" => "352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10999875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythema multiforme due to Mycoplasma pneumoniae infection in two children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;C&#46; Schalock"
                            1 => "J&#46;G&#46;H&#46; Dinulos"
                            2 => "N&#46; Pace"
                            3 => "K&#46; Schwarzenberger"
                            4 => "J&#46;K&#46; Wenger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1525-1470.2006.00307.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "23"
                        "paginaInicial" => "546"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17155996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycoplasma pneumoniae-induced rash and mucositis as a syndrome distinct from Stevens-Johnson syndrome and erythema multiforme&#46; A systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;N&#46; Canavan"
                            1 => "E&#46;F&#46; Mathes"
                            2 => "I&#46; Frieden"
                            3 => "K&#46; Shinkai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2014.06.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2015"
                        "volumen" => "72"
                        "paginaInicial" => "239"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25592340"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exudado uretral y afectaci&#243;n mucocut&#225;nea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Toledo-Pastrana"
                            1 => "A&#46; Zapata-L&#243;pez"
                            2 => "A&#46; Mich&#225;n-Do&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2014.04.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2014"
                        "volumen" => "214"
                        "paginaInicial" => "e91"
                        "paginaFinal" => "e92"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24889773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "14"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41;&#58; An original multisystem adverse drug reaction&#59; results from the prospective RegiSCAR study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;H&#46; Kardaun"
                            1 => "P&#46; Sekula"
                            2 => "L&#46; Valeyrie-Allanore"
                            3 => "Y&#46; Liss"
                            4 => "C&#46;Y&#46; Chu"
                            5 => "D&#46; Creamer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.12501"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "169"
                        "paginaInicial" => "1071"
                        "paginaFinal" => "1080"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23855313"
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        "identificador" => "xack277918"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0080" class="elsevierStylePara elsevierViewall">We would like to thank Dr&#46; Paola Bar&#243;n Rodiz&#44; of the radiology department of our hospital&#44; for her collaboration&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
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      "titulo" => "e- Case Report"
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Información del artículo
ISSN: 15782190
Idioma original: Inglés
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