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Severe Mucha–Habermann‐Like Ulceronecrotic Skin Disease in T‐Cell Acute Lymphoblastic Leukemia Responsive to Basiliximab and Stem Cell Transplant
Author(s) -
Orenstein Lauren A.V.,
Coughlin Carrie. C.,
Flynn Andrea T.,
Pillai Vinodh,
Boos Markus D.,
Wertheim Gerald B.,
Treat James R.,
Teachey David T.
Publication year - 2017
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13235
Subject(s) - medicine , basiliximab , chemotherapy , leukemia , acute lymphocytic leukemia , immunology , hematopoietic stem cell transplantation , transplantation , malignancy , dermatology , pathology , disease , lymphoblastic leukemia , induction therapy
A 5‐year‐old girl with T‐cell acute lymphoblastic leukemia (T‐ ALL ) developed a progressive eruption of crusted papules and ulcerative plaques involving 80% of her body surface area with histopathology consistent with febrile ulceronecrotic Mucha–Habermann disease ( FUMHD ), although multiple specimens also contained clonal leukemic cells. Her skin disease was refractory to many classic treatments for FUMHD , including methotrexate, and became so severe that concern about superinfection prevented intensification of chemotherapy for her malignancy. The addition of basiliximab promoted gradual improvement of the skin, allowing for chemotherapy intensification and subsequent bone marrow transplantation, after which the eruption resolved completely. This report describes a severe case of FUMHD ‐like eruption associated with clonal leukemic cells that improved with basiliximab, suggesting anti‐ CD 25 therapy as a novel treatment for ulceronecrotic skin disease in the setting of high interleukin‐2 levels.