Pityriasis lichenoides et varioliformis acuta: A rare association with the measles, mumps and rubella vaccine

Abstract

The aetiology of pityriasis lichenoides (PL) is unknown. One major pathogenic theory suggests that PL is a lymphoproliferative disease or inflammatory reaction triggered by an antigenic stimulus, such as a virus or other infectious agent. We report the second case of PL et varioliformis acuta (PLEVA) occurring after measles vaccination and the first following the combined measles, mumps, rubella vaccination.

Pityriasis Lichenoides in Childhood: Review of Clinical Presentation and Treatment Options

“…The role of tonsillectomy in the management of PL occurring in the setting of recurrent streptococcal infections remains controversial because there are reports of improvement and of persistence and exacerbation after this intervention . There are also rare reports of PL occurring in children after MMR (measles, mumps, and rubella), influenza, and hepatitis B immunizations .…”

“…The role of tonsillectomy in the management of PL occurring in the setting of recurrent streptococcal infections remains controversial because there are reports of improvement and of persistence and exacerbation after this intervention (26,27). There are also rare reports of PL occurring in children after MMR (measles, mumps, and rubella), influenza, and hepatitis B immunizations (13,28,29). There were 17 reported cases in which the development of PL was associated with recent medication administration (7,8,13), including antibiotics and acetaminophen (7).…”

Possible role of plasmacytoid dendritic cells in pityriasis lichenoides

“…In addition to the already mentioned frequent association of PL with different viral infections, 1 PL has also been reported in association with viral vaccinations such as the influenza vaccine and the measles, mumps and rubella vaccine. 27,28 In such cases, it may be that the injury from vaccination and/or the crossreactivity between viral proteins used in the different viral vaccines and shared epitopes on keratinocytes induces loss of tolerance, leading to PL development, especially given that pDCs are known to be mainly recruited to skin areas of viral infection/ proteins or injury.…”

A case of pityriasis lichenoides: Rapid resolution with azithromycin monotherapy in 3 weeks

“…Topical corticosteroids, calcineurin inhibitors, and oral antibiotics (tetracycline, erythromycin) as a first-step; phototherapy (UVB or PUVA) as a second-step and systemic steroid, cyclosporine, methotrexate, acitretin, and dapsone as a third-step treatment may be used (Fernandes et al, 2010). A response rate of 75% with minocycline treatment in adults was reported (Gunatheesan, Ferguson, & Moosa, 2012).…”