title: Resistant pityriasis lichenoides et varioliformis acuta in a 3-year-old boy: successful treatment with methotrexate.
abstract: Pityriasis lichenoides et varioliformis acuta (PLEVA) represents the acute clinical subtype of pityriasis lichenoides (PL) and its occurrence is relatively common during childhood. Diagnosis and treatment may sometimes pose certain difficulties. We present the recalcitrant case of a 3-year-old boy with an asymptomatic polymorphic eruption consisting of multiple, scattered, 0.5 cm, round to ovoid, erythematous papules covered in places with a fine scale, vesicles and superficial erosions with thick hemorrhagic crusts. The correlation of the clinical features with the lesional histopathology favored the diagnosis of PLEVA. No first-line treatment scheme succeeded in controlling the eruption of new lesions. The only therapeutic approach that eventually managed to cease the disease evolution was the combination of prednisolone and methotrexate.
authors.affiliation: First Departments of Dermatology & Venereology, Aristotle University Medical School, Thessaloniki, Greece. bethlaz@med.auth.gr
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lazaridou
authors.forename: Christina
authors.initials: C
authors.lastname: Fotiadou
authors.forename: Christina
authors.initials: C
authors.lastname: Tsorova
authors.forename: Maria
authors.initials: M
authors.lastname: Trachana
authors.forename: Anastasia
authors.initials: A
authors.lastname: Trigoni
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Patsatsi
authors.forename: Demetris
authors.initials: D
authors.lastname: Ioannides
mesh_terms: D001707:Biopsy, Needle; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D017514:Pityriasis Lichenoides / Q000175:diagnosis* / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone; D008727:Methotrexate