(PLEVA, Acuta lichenoides and varioliformis pityriasis )

Extremely rare. Acute form of pityriasis lichenoides (or drip-shaped parapsoriasis ). Cutaneous inflammatory disease of unknown origin: inflammatory proliferation in response to an infectious agent (HIV, CMV, EBV, parvovirus 19) ? More frequent among boys (peaks at the age of 5 and 10 years), especially in autumn and winter.

Macular then papulo-vesicular eruption, initially on the chest and with lesions of different age. Pruritus is sometimes present. A necrotizing ulcerative form is possible. With regard to the clinical picture, the first diagnosis is generally varicella. Forms with high fever, mucous membranes involvement and adenopathies are severe and can be lethal in case of delayed treatment.

Treatment: according to the severity of the lesions,

-        topical and/or systemic corticosteroids

-        erythromycin by mouth

-        methotrexate IV

-        sometimes gamma globulin IV

Anesthetic implications:

fragile skin, side effects of corticosteroids

References : 

-         Dupin A, Bosset D, Atger L, Chevallier B, Saiag P, Benoist G.
Maladie de Mucha-Habermann fébrile et nécrotique.
Arch Pédiatr 2016 ; 23 :82-5.

Updated: December 2018