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Febrile ulceronecrotic Mucha-Habermann's disease with pulmonary involvement

Li-xin Zhang1, Yuan Liang, Ying Liu

  • 1Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing, China.

Pediatric Dermatology
|July 9, 2010
PubMed

Insights

Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a severe condition that can be triggered by measles virus vaccination in children. Successful treatment involves a combination of high-dose corticosteroids and methotrexate (MTX).

Area of Science:

  • Pediatric Dermatology
  • Vaccine Immunology
  • Systemic Inflammatory Diseases

Background:

  • Pityriasis lichenoides et varioliformis acuta (PLEVA) is a rare benign skin condition.
  • Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a severe variant of PLEVA.
  • Vaccine-induced adverse events can manifest with diverse dermatological presentations.

Observation:

  • A 12-year-old boy developed FUMHD following measles virus vaccination.
  • Clinical presentation included extensive polymorphous, papular, and ulcerohemorrhagic skin lesions, fever, hepatic dysfunction, and hypoalbuminemia.
  • Thoracic CT revealed parenchymal nodular infiltration; skin biopsy showed features of PLEVA and allergic vasculitis.

Findings:

  • The patient's FUMHD was potentially triggered by the measles virus vaccine.
  • Histopathology confirmed a mixed picture of PLEVA and allergic vasculitis.
  • Successful treatment was achieved with prednisolone and methotrexate (MTX).

Implications:

  • This case suggests a possible causal link between measles virus vaccination and FUMHD in susceptible children.
  • Highlights the importance of considering vaccination as a potential trigger for severe cutaneous reactions.
  • Demonstrates the efficacy of combining systemic methotrexate and high-dose corticosteroids for managing FUMHD in pediatric patients.

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