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A case highlights diagnostic challenges in managing lesions caused by herpes virus vs. methotrexate toxicity.
A 56-year-old female on long-term methotrexate presented with painful oral ulcerations diagnosed as erythema multiforme. Despite continued methotrexate use, lesions resolved with acyclovir and corticosteroids, confirming herpes simplex virus-associated erythema multiforme. This case highlights the importance of therapeutic response in distinguishing viral triggers from drug-induced causes for accurate management.
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Mohapatra et al. (2026) studied this question.
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