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Detection of cytomegalovirus infection in a patient with febrile ulceronecrotic Mucha-Habermann's disease

Authors

  • Kau-Sung Tsai MD,

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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  • Hsu-Jung Hsieh MD,

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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  • Kuan-Chih Chow PhD,

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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  • Tze-Yi Lin MD, PhD,

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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  • Shu-Fen Chiang MSC,

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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  • Hsuan-Hua Huang MD, PhD

    1. From the Departments of Dermatology, Medical Research and Pathology, China Medical College Hospital and China Medical College, Taichung, Taiwan
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Kuan-Chih Chow, PhD
Department of Medical Research
China Medical College Hospital and China Medical College
2 Yuh-Der Road
Taichung 40442
Taiwan
E-mail: t6218@hpd.cmch.org.tw

Abstract

Abstract

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.

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