Detection of cytomegalovirus infection in a patient with febrile ulceronecrotic Mucha-Habermann's disease.
BACKGROUND
Febrile ulceronecrotic Mucha-Habermann's disease (FUMHD) is a severe and very rare variant of pityriasis lichenoides et varilioformis acuta, which is characterized by large coalescing, and ulceronecrotic maculopapules or plaques. Morphological changes of the skin accompanied by persistent high fever and several constitutional symptoms have suggested virus infection in patients with FUMHD. However, the available information of viral origin is limited. In this study we investigated the relationship of cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 8 (HHV8), type I human T-cell lymphotropic virus (HTLV-I), and parvovirus B19 (PVB19) with FUMHD in a Taiwanese patient.


METHODS
The existence of CMV, EBV, HHV8, HTLV-I, and PVB19 was determined by polymerase chain reaction (PCR). The presence of CMV in the endothelial cells was characterized by in situ hybridization (ISH) and immunohistochemistry (IHC).


RESULTS
Serologic immunoglobulin to CMV and IHC identification of CMV late gene in the biopsy specimen indicated that the patient was infected with CMV. Detection of CMV was confirmed by PCR and ISH.


CONCLUSIONS
These results indicate that FUMHD is associated with dermal CMV manifestation. Nonetheless, the induction mechanism of FUMHD with CMV infection has yet to be determined.
Tsai
K S
KS
Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan.
Hsieh
H J
HJ
Chow
K C
KC
Lin
T Y
TY
Chiang
S F
SF
Huang
H H
HH
D000212:Acyclovir / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005334:Fever / Q000150:complications / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010789:Phototherapy / Q000379:methods; D017514:Pityriasis Lichenoides / Q000150:complications* / Q000473:pathology*; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents; D000212:Acyclovir