RESUMO
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD), a lymphocyte-mediated inflammatory skin disorder, is considered a severe variant of pityriasis lichenoides et varioliformis acuta that can lead to a fatal outcome if not managed in a timely fashion. Children with FUMHD can have systemic complications involving various organs. The scarcity of reported cases and the absence of well-designed studies or randomized clinical trials to evaluate different therapeutic modalities pose a major challenge in treating this potentially life-threatening disorder. We report a five-year-old child with FUMHD and seizures treated unsuccessfully with a combination of systemic steroids, methotrexate, dapsone, and oral erythromycin, who improved rapidly and achieved disease control with just a single infusion of low-dose intravenous immunoglobulin.
Assuntos
Imunoglobulinas Intravenosas , Pitiríase Liquenoide , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Pitiríase Liquenoide/tratamento farmacológico , Pré-Escolar , Masculino , Fatores Imunológicos/uso terapêutico , Febre/etiologia , Febre/tratamento farmacológicoRESUMO
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare, potentially fatal subtype of pityriasis lichenoides et varioliformis acuta (PLEVA). Herein, we present a rare case of a 14-year-old male without significant past medical history who was diagnosed with FUMHD without a clear inciting factor. He was effectively treated with systemic corticosteroids with complete resolution of symptoms.
Assuntos
Herpes Simples , Pitiríase Liquenoide , Masculino , Humanos , Adolescente , Pitiríase Liquenoide/diagnóstico , Pitiríase Liquenoide/tratamento farmacológico , CorticosteroidesRESUMO
We observed ten children with a papular eruption with purpuric features during the SARS-CoV-2 pandemic in Northern Italy (May-December 2020). Histological examination showed signs of SARS-CoV-2-related dermatosis. Evidence of nucleocapsid viral proteins using SARS-CoV-2 (2019-nCoV) nucleocapsid antibody revealed cuticular staining of the deep portion of the eccrine glands in all cases.
Assuntos
COVID-19 , Dermatite , Púrpura , Humanos , Pandemias , Púrpura/etiologia , SARS-CoV-2RESUMO
Pityriasis lichenoides (PL) is an uncommon cutaneous disorder. Oral erythromycin is proposed to be effective in treating the disease. Here, we reported 16 pediatric patients with PL and systematically reviewed published literatures on erythromycin treatment response in pediatric PL patients, to observe the different treatment response to erythromycin in the pityriasis lichenoides chronica (PLC) and the pityriasis lichenoides et varioliformis acuta (PLEVA) groups. Sixteen patients, 8 with PLC and 8 with PLEVA, were treated with erythromycin. In the PLC group, 25% (n = 2) patients responded to erythromycin, while in the PLEVA group, 87.5% (n = 7) patients responded to erythromycin. The response rate was higher in the PLEVA group than the PLC group (P =.05). No side effect was reported in the 16 patients. A total of 34 children including 16 from our studies were included for further descriptive analysis, in which 12 had PLC and 22 had PLEVA. In the PLC group, 41.7% (n = 5) of patients responded to erythromycin while in the PLEVA group, 90.9 % (n = 20) of patients responded. The response rate was higher in the PLEVA group than the PLC group (P = .004). In conclusion, erythromycin is effective and safe in the treatment of children with PL, and erythromycin was more effective in patients with PLEVA than PLC.
Assuntos
Pitiríase Liquenoide , Criança , Eritromicina , Humanos , Pitiríase Liquenoide/diagnóstico , Pitiríase Liquenoide/tratamento farmacológicoRESUMO
Papulo- and vesiculo-necrotic lesions are rare manifestations of secondary syphilis. Until now it has been described only in HIV-infected patients with advanced stages of immunosuppression. This case report describes an unusual case of PLEVA-like syphilis in a 33-year-old man with newly diagnosed HIV infection. Despite that the CD4 cells level and viral load did not indicate the advance stage of immunosuppression, the unusual manifestation of syphilis and neurosyphilis occurred. The presented case indicates the need for HIV screening in every patient with syphilis especially when the clinical manifestation is unusual. Importance of syphilis testing in every case with atypical rashes should be also highlighted.
RESUMO
Purpose of Review: Pityriasis lichenoides (PL) is a spectrum of dermatological conditions involving polymorphous lesions. Natural history of the condition ranges from acute to chronic. Cases of PL following SARS-CoV-2 infection/vaccination have been reported, but not yet comprehensively reviewed. Hence, the objective of this article is to review and summarize cases of PL following SARS-CoV-2 infection/vaccination in order to guide clinicians in its diagnosis and management. Recent Findings: PubMed, Embase, and Web of Science were searched for relevant articles. Thirteen articles, consisting of 14 cases of PL following SARS-CoV-2 infection/vaccination, were identified. Males represented 64.3% of cases, and the average age of those affected was 41.4 years. The majority of cases (N = 9, 64.3%) were following SARS-CoV-2 vaccination, the most commonly implicated being Pfizer-BioNTech (n = 8/10, 80%), while four (28.6) followed infection. The overall latency period ranged from 5 days to 1 month. Treatments varied greatly. However, at the time of follow-up, 12/14 patients (85.7%) had either marked improvement or complete resolution of lesions. Summary: This review cannot determine causality. However, a temporal association was observed with the case reports, and one case of PL followed SARS-CoV-2 infection and recurred with subsequent vaccination, suggesting an association. Nevertheless, risk of developing PL following SARS-CoV-2 infection/vaccination is likely extremely low. There is also the possibility these cases are purely coincidental. Still, clinicians should be aware of this possible etiology when diagnosing a new or exacerbated case of PL. Finally, given that the majority of patients had marked improvement or complete resolution of lesions at the time of follow-up, clinicians should provide reassurance to their affected patients.
RESUMO
Pityriasis lichenoides is an acute and/or chronic skin disease associated with recurrent erythematous papules that self-resolve. While its etiology is unknown, preceding viral infection may play a role. We present an atypical case of a 40-year-old woman with pityriasis lichenoides et varioliformis acuta as a complication of a COVID-19 infection.
RESUMO
Pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica represent 2 ends of a disease spectrum of unknown etiology. Herein we describe 2 cases of pityriasis lichenoides et varioliformis acuta, in which human herpesvirus 7 DNA was detected in skin samples by polymerase chain reaction methodology, an association not previously described. This report may support the involvement of viral infection in the etiopathogeny of this disease.
Assuntos
Infecções por Herpesviridae/virologia , Herpesvirus Humano 7/isolamento & purificação , Pitiríase Liquenoide/virologia , Adulto , DNA Viral/análise , Diagnóstico Diferencial , Feminino , Infecções por Herpesviridae/diagnóstico , Herpesvirus Humano 7/genética , Herpesvirus Humano 7/patogenicidade , Humanos , Masculino , Pitiríase Liquenoide/patologia , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
A pitiríase liquenóide e varioliforme aguda (PLEVA), é classificada dentro do grupo de dermatoses crônicas, idiopáticas, chamado de "parapsoríases". Caracteriza-se por erupção aguda ou subaguda de múltiplas e pequenas pápulas eritematosas, que podem evoluir com vesiculação e necrose hemorrágica central. A fototerapia possui altos níveis de eficácia e tolerabilidade em uma variedade de doenças inflamatórias e neoplásicas da pele caracterizadas por infiltrados epiteliais e dérmicos rico em linfócitos T . Este artigo relata o caso de uma mulher de meia idade com apresentação clínica típica e diagnóstico histopatológico de PLEVA. Por se tratar de doença que nem sempre responde a tratamentos sistêmicos, o objetivo da proposta terapêutica com fototerapia visou suprimir a doença por seu efeito anti-inflamatório e imunossupressor e prevenir a evolução para o linfoma cutâneo de células T.
Pityriasis lichenoid et varioliformis acute (PLEVA) is classified within the group of chronic, idiopathic dermatoses called "parapsoriasis". It is characterized by an acute or subacute eruption of multiple small erythematous papules, which may progress to vesiculation and central hemorrhagic necrosis. Phototherapy has high levels of efficacy and tolerability in a variety of inflammatory and neoplastic skin diseases characterized by epithelial and dermal infiltrates rich in T lymphocytes. This article reports the case of a middle-aged woman with typical clinical presentation and histopathological diagnosis of PLEVA. As it is a disease that does not always respond to systemic treatments, the objective of the therapeutic proposal with phototherapy was to suppress the disease due to its anti-inflammatory and immunosuppressive effect and prevent the evolution to cutaneous T-cell lymphoma.