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Pityriasis lichenoides et varioliformis acuta: case report A 6-year-old boy developed pityriasis lichenoides et varioliformis acuta following vaccination with measles and rubella virus vaccine [route and dosage not stated]. The boy presented to the dermatology department with an 8-day history of reddish lesions over his extremities and trunk. Initially, these lesions were asymptomatic, but later these lesions became itchy. He did not have fever or any constitutional symptoms. An anamnesis showed that he had administered measles and rubella virus vaccine [measles rubella vaccine] 7 days before the onset of lesions. His previous vaccinations were uneventful, and he was not on any medications. Cutaneous examination showed multiple, discrete erythematous papules, some with crusting, which was noted bilaterally over the trunk, face and limbs. He had a few erosions over the abdomen and legs. His systemic examination was unremarkable. Based on these findings, a diagnosis of pityriasis lichenoides et varioliformis acuta was suspected. Skin biopsy from an erythematous papule on the trunk demonstrated epidermis displaying parakeratosis, necrosis of keratinocytes and basal cell vacuolar degeneration. Superficial dermis showed perivascular and interstitial lymphocytic infiltrate. Pigment incontinence was also noted. Based on the clinical presentation, the diagnosis of pityriasis lichenoides et varioliformis acuta was confirmed, which was attributed to measles and rubella virus vaccine. The boy was treated with azithromycin and unspecified systemic steroids for 2 weeks. He also received narrow‑band ultraviolet‑B phototherapy. Further, the onset of new lesions stopped within 2–3 weeks of the therapy, and eventually, the existing lesions resolved by 2 months. Narrow‑band ultraviolet‑B phototherapy was continued for another 2 weeks and then discontinued. The lesions healed with pigmentation and atrophic scarring. Rechallenge was not performed. Shastry V, et al. Pityriasis lichenoides et varioliformis acuta following measles rubella vaccine. Indian Journal of Dermatology, Venereology and Leprology 86: 398-400, No. 803498296 4, Aug 2020. Available from: URL: http://doi.org/10.4103/ijdvl.IJDVL_48_18

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