Febrile Ulceronecrotic Mucha-Habermann Disease: A Case Report and Review of Literature in the Paediatric Population
DOI:
https://doi.org/10.2340/actadv.v103.4806Keywords:
febrile ulceronecrotic Mucha-Habermann disease, FUMHD, pityriasis lichenoides et varioliformis acuta, PLEVAAbstract
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare fulminant variant of pityriasis lichenoides et varioliformis acuta (PLEVA) that is characterized by a large ulceronecrotic appearance with high fever and a variety of systemic symptoms. We report here a case of FUMHD in a 17-year-old male Chinese patient who was treated successfully with a combination therapy of methotrexate, methylprednisolone, and intravenous immunoglobulin. In addition, a literature review was conducted to summarize the key characteristics of paediatric FUMHD cases.
Downloads
References
Degos R DB, Daniel F. Le parapsoriasis ulcéro-nécrotique hyperthermique. Ann Dermatol Syphiligr (Paris) 1966; 93: 481-496.
https://doi.org/10.1001/archderm.1966.01600220108032 DOI: https://doi.org/10.1001/archderm.1966.01600220108032
Weins AB, Theiler M, Bogatu B, Kerl K, Pleimes M, Pachlopnik-Schmid J, et al. Febrile ulceronecrotic Mucha-Habermann disease mimicking Kawasaki disease. J Dtsch Dermatol Ges 2020; 18: 140-142. DOI: https://doi.org/10.1111/ddg.13989_g
https://doi.org/10.1111/ddg.13989 DOI: https://doi.org/10.1111/ddg.13989
Tang P, Chen JS, Wang H, Yang H. Febrile ulceronecrotic Mucha-Habermann disease: a case report and a systematic review. Case Rep Dermatol 2022; 14: 169-177.
https://doi.org/10.1159/000525008 DOI: https://doi.org/10.1159/000525008
Yamada K, Motegi S-i, Matsushima Y. Febrile ulceronecrotic Mucha-Habermann disease in a young boy: a case report and review of the literature. Acta Derm Venereol 2014; 94: 603-604.
https://doi.org/10.2340/00015555-1791 DOI: https://doi.org/10.2340/00015555-1791
Nofal A, Assaf M, Alakad R, Amer H, Nofal E, Yosef A. Febrile ulceronecrotic Mucha-Habermann disease: proposed diagnostic criteria and therapeutic evaluation. Int J Dermatol 2016; 55: 729-738.
https://doi.org/10.1111/ijd.13195 DOI: https://doi.org/10.1111/ijd.13195
Tsai KS, Hsieh HJ, Chow KC, Lin TY, Chiang SF, Huang HH. Detection of cytomegalovirus infection in a patient with febrile ulceronecrotic Mucha-Habermann's disease. Int J Dermatol 2001; 40: 694-698.
https://doi.org/10.1046/j.1365-4362.2001.01301.x DOI: https://doi.org/10.1046/j.1365-4362.2001.01301.x
Smith JJL, Oliver GF. Febrile ulceronecrotic Mucha-Habermann disease associated with herpes simplex virus type 2. J Am Acad Dermatol 2009; 60: 149-152.
https://doi.org/10.1016/j.jaad.2008.07.036 DOI: https://doi.org/10.1016/j.jaad.2008.07.036
Lode HN, Döring P, Lauenstein P, Hoeger P, Dombrowski F, Bruns R. Febrile ulceronecrotic Mucha-Habermann disease following suspected hemorrhagic chickenpox infection in a 20-month-old boy. Infection 2015; 43: 583-588.
https://doi.org/10.1007/s15010-015-0726-5 DOI: https://doi.org/10.1007/s15010-015-0726-5
Tsianakas A, Hoeger PH. Transition of pityriasis lichenoides et varioliformis acuta to febrile ulceronecrotic Mucha- Habermann disease is associated with elevated serum tumour necrosis factor-α. Br J Dermatol 2005; 152: 794-799.
https://doi.org/10.1111/j.1365-2133.2005.06485.x DOI: https://doi.org/10.1111/j.1365-2133.2005.06485.x
Wu R, DiLorenzo A, Lotke M, Habeshian K, Brooks J, Keller MD, et al. Evaluation and treatment of febrile ulceronecrotic mucha-habermann disease with ruxolitinib and tocilizumab as guided by cytokine profile. JAMA Dermatol 2021; 157: 1381-1383.
https://doi.org/10.1001/jamadermatol.2021.4047 DOI: https://doi.org/10.1001/jamadermatol.2021.4047
Cozzio A, Haffner J, Kempf W, Haffner A, Palmedo G, Michaelis S, et al. Febrile ulceronecrotic Mucha-Habermann disease with clonality: a cutaneous T-cell lymphoma entity? J Am Acad Dermatol 2004; 51: 1014-1017.
https://doi.org/10.1016/j.jaad.2004.06.009 DOI: https://doi.org/10.1016/j.jaad.2004.06.009
Nofal A, Alakad R, Assaf M, Nofal E. A fatal case of febrile ulceronecrotic Mucha-Habermann disease in a child. JAAD Case Rep 2016; 2: 181-185.
https://doi.org/10.1016/j.jdcr.2016.03.002 DOI: https://doi.org/10.1016/j.jdcr.2016.03.002
Singh G, Arora S, Das P, Gupta A. A fatal case of febrile ulceronecrotic mucha-habermann disease in a 10-year-old boy. Indian Dermatol Online J 2022; 13: 535-538.
https://doi.org/10.4103/idoj.idoj_472_21 DOI: https://doi.org/10.4103/idoj.idoj_472_21
Blohm ME, Ebenebe CU, Rau C, Escherich C, Johannsen J, Escherich G, et al. Mucha-Habermann disease: a pediatric case report and proposal of a risk score. Int J Dermatol 2021; 61: 401-409.
https://doi.org/10.1111/ijd.15770 DOI: https://doi.org/10.1111/ijd.15770
Griffith-Bauer K, Leitenberger SL, Krol A. Febrile ulceronecrotic Mucha-Habermann disease: two cases with excellent response to methotrexate. Pediatr Dermatol 2015; 32: e307-e308.
https://doi.org/10.1111/pde.12687 DOI: https://doi.org/10.1111/pde.12687
Burke DP, Adams RM, Arundell FD. Febrile ulceronecrotic mucha Habermann's disease. Arch Dermatol 1969; 100: 200-206. DOI: https://doi.org/10.1001/archderm.100.2.200
https://doi.org/10.1001/archderm.1969.01610260076014 DOI: https://doi.org/10.1001/archderm.1969.01610260076014
Auster BI, Santa Cruz DJ, Eisen AZ. Febrile ulceronecrotic Mucha-Habermann's disease with interstitial pneumonitis. J Cutan Pathol 1979; 6: 66-76.
https://doi.org/10.1111/j.1600-0560.1979.tb00307.x DOI: https://doi.org/10.1111/j.1600-0560.1979.tb00307.x
Luberti AA, Rabinowitz LG, Ververeli KO. Severe febrile Mucha-Habermann's disease in children: case report and review of the literature. Pediatr Dermatol 1991; 8: 51-57.
https://doi.org/10.1111/j.1525-1470.1991.tb00841.x DOI: https://doi.org/10.1111/j.1525-1470.1991.tb00841.x
Fink-Puches R, Soyer HP, Kerl H. Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta. J Am Acad Dermatol 1994; 30: 261-263.
https://doi.org/10.1016/S0190-9622(08)81921-4 DOI: https://doi.org/10.1016/S0190-9622(08)81921-4
Maekawa Y, Nakamura T, Nogami R. Febrile ulceronecrotic Mucha-Habermann's disease. J Dermatol 1994; 21: 46-49.
https://doi.org/10.1111/j.1346-8138.1994.tb01409.x DOI: https://doi.org/10.1111/j.1346-8138.1994.tb01409.x
Romani J, Puig L, Fernandez-Figueras MT, de Moragas JM. Pityriasis lichenoides in children: clinicopathologic review of 22 patients. Pediatr Dermatol 1998; 15: 1-6.
https://doi.org/10.1046/j.1525-1470.1998.1998015001.x DOI: https://doi.org/10.1046/j.1525-1470.1998.1998015001.x
Hsieh CG CY, Ho JC, Huang SC. Febrile ulceronecrotic Mucha-Habermann's disease. Dermatoogical Sinica 2001; 19: 233-242
Ricci G, Patrizi A, Misciali D, Masi M. Pathological case of the month. Febrile Mucha-Haberman disease. Arch Pediat Adol Med 2001; 155: 195-196.
https://doi.org/10.1001/archpedi.155.2.195 DOI: https://doi.org/10.1001/archpedi.155.2.195
Yang CC, Lee JY, Chen W. Febrile ulceronecrotic Mucha-Habermann disease with extensive skin necrosis in intertriginous areas. Eur J Dermatol 2003; 13: 493-496.
Ito N, Ohshima A, Hashizume H, Takigawa M, Tokura Y. Febrile ulceronecrotic Mucha-Habermann's disease managed with methylprednisolone semipulse and subsequent methotrexate therapies. J Am Acad Dermatol 2003; 49: 1142-1148.
https://doi.org/10.1016/S0190-9622(03)00461-4 DOI: https://doi.org/10.1016/S0190-9622(03)00461-4
Herron MD, Bohnsack JF, Vanderhooft SL. Septic, CD-30 positive febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta. Pediatr Dermatol 2005; 22: 360-365.
https://doi.org/10.1111/j.1525-1470.2005.22418.x DOI: https://doi.org/10.1111/j.1525-1470.2005.22418.x
Kim HS, Yu DS, Kim JW. A case of febrile ulceronecrotic Mucha-Habermann's disease successfully treated with oral cyclosporin. J Eur Acad Dermatol Venereol 2007; 21: 272-273.
https://doi.org/10.1111/j.1468-3083.2006.01843.x DOI: https://doi.org/10.1111/j.1468-3083.2006.01843.x
Pyrpasopoulou A, Athyros VG, Karagiannis A, Chrysomallis F, Zamboulis C. Intravenous immunoglobulins: a valuable asset in the treatment of a case of septic febrile ulceronecrotic Mucha-Habermann disease. Dermatology 2007; 215: 164-165.
https://doi.org/10.1159/000104271 DOI: https://doi.org/10.1159/000104271
Helbling I, Chalmers RJ, Yates VM. Febrile ulceronecrotic Mucha-Habermann disease: a rare dermatological emergency. Clin Exp Dermatol 2009; 34: e1006-1007.
https://doi.org/10.1111/j.1365-2230.2009.03666.x DOI: https://doi.org/10.1111/j.1365-2230.2009.03666.x
Zhang LX, Liang Y, Liu Y, Ma L. Febrile ulceronecrotic Mucha-Habermann's disease with pulmonary involvement. Pediatr Dermatol 2010; 27: 290-293.
https://doi.org/10.1111/j.1525-1470.2010.01141.x DOI: https://doi.org/10.1111/j.1525-1470.2010.01141.x
Kaufman WS, McNamara EK, Curtis AR, Kosari P, Jorizzo JL, Krowchuk DP. Febrile ulceronecrotic Mucha-Habermann disease (pityriasis lichenoides et varioliformis acuta fulminans) presenting as Stevens-Johnson syndrome. Pediatr Dermatol 2012; 29: 135-140.
https://doi.org/10.1111/j.1525-1470.2011.01608.x DOI: https://doi.org/10.1111/j.1525-1470.2011.01608.x
Perrin BS, Yan AC, Treat JR. Febrile ulceronecrotic Mucha-Habermann disease in a 34-month-old boy: a case report and review of the literature. Pediatr Dermatol 2012; 29: 53-58.
https://doi.org/10.1111/j.1525-1470.2011.01531.x DOI: https://doi.org/10.1111/j.1525-1470.2011.01531.x
Lin CY, Cook J, Purvis D. Febrile ulceronecrotic Mucha- Habermann disease: a case with systemic symptoms managed with subcutaneous methotrexate. Australas J Dermatol 2012; 53: e83-e86.
https://doi.org/10.1111/j.1440-0960.2011.00812.x DOI: https://doi.org/10.1111/j.1440-0960.2011.00812.x
Rosman IS, Liang L-C, Patil S, Bayliss SJ, White AJ. Febrile ulceronecrotic Mucha-Habermann disease with central nervous system vasculitis. Pediatr Dermatol 2013; 30: 90-93.
https://doi.org/10.1111/j.1525-1470.2011.01669.x DOI: https://doi.org/10.1111/j.1525-1470.2011.01669.x
Nanda A, Alshalfan F, Al-Otaibi M, Al-Sabah H, Rajy JM. Febrile ulceronecrotic Mucha-Habermann disease (pityriasis lichenoides et varioliformis acuta fulminans) associated with parvovirus infection. Am J Dermatopathol 2013; 35: 503-506.
https://doi.org/10.1097/DAD.0b013e3182770626 DOI: https://doi.org/10.1097/DAD.0b013e3182770626
Luo DQ. Febrile ulceronecrotic Mucha-Habermann disease. Cutis 2013; 92: E9-E12.
Hervas JA, Martin-Santiago A, Hervas D, Gomez C, Duenas J, Reina J. Varicella precipitating febrile ulceronecrotic Mucha-Habermann disease. Pediatr Dermatol 2013; 30: e216-217.
https://doi.org/10.1111/pde.12008 DOI: https://doi.org/10.1111/pde.12008
Uzoma MA, Wilkerson MG, Carr VL, Westhoven GS, Raimer SA. Pentoxifylline and cyclosporine in the treatment of febrile ulceronecrotic Mucha-Habermann disease. Pediatr Dermatol 2014; 31: 525-527.
https://doi.org/10.1111/j.1525-1470.2012.01862.x DOI: https://doi.org/10.1111/j.1525-1470.2012.01862.x
Bulur I, Kaya Erdoğan H, Nurhan Saracoglu Z, Arık D. Methotrexate treatment in children with febrile ulceronecrotic Mucha-Habermann disease: case report and literature review. Case Rep Dermatol Med 2015; 2015: 357973.
https://doi.org/10.1155/2015/357973 DOI: https://doi.org/10.1155/2015/357973
Alratrout J, Alshammasi F, Ansari N. Febrile ulceronecrotic Mucha-Habermann disease in an 8-year-old boy responding to methotrexate. Int J Dermatol 2016; 55: 1205-1209.
https://doi.org/10.1111/ijd.13323 DOI: https://doi.org/10.1111/ijd.13323
Kilgallon K, Urs J, Fernandez Faith E. Visual diagnosis: severe ulceronecrotic eruption with systemic symptoms. Pediatr Rev 2018; 39: e54-e56.
https://doi.org/10.1542/pir.2017-0039 DOI: https://doi.org/10.1542/pir.2017-0039
Wang B, Li J, Xie H-f, Chen M, Li B, Shi W. Striking case of febrile ulceronecrotic Mucha-Habermann disease responding to lymphoplasmapheresis and methotrexate. J Dermatol 2020; 47: E430-E431.
https://doi.org/10.1111/1346-8138.15598 DOI: https://doi.org/10.1111/1346-8138.15598
Schaan de Souza M, Perinazzo Pauvels LS, Martins Costa Jappur D, Poy Dondonis F, da Silva M, da Silva Cartell A, et al. Combination therapy with cyclosporine and intravenous immunoglobulin for febrile ulcerative Mucha-Habermann disease. Dermatol Ther 2021; 34: e14655.
https://doi.org/10.1111/dth.14655 DOI: https://doi.org/10.1111/dth.14655
Additional Files
Published
How to Cite
License
Copyright (c) 2023 Jue Liu, Jianbo Zhong, Qiaowei Wang, Yinglian Cai, Jian Chen
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.