A CASE OF INFANTILE FEBRILE PSORIASIFORM DERMATITIS

An infant suffered from psoriasiform dermatitis complicated by severe constitutional symptoms. During his 12 months of hospitalization, the symptoms exacerbated periodically despite numerous therapeutic trials. Histologic findings revealed lichenoid psoriasiform dermatitis with s triking eosinophilic necrosis of epidermal cells and satellite cell ne crosis. Immunohistochemically, CD1(+) Langerhans cells had almost disa ppeared, and CD8(+) cytotoxic-suppressor T cells were predominant over CD4(+) helper-inducer T cells in the epidermis. These findings in the skin biopsy specimens suggested some similarity to graft-versus-host disease but no known cause of that disorder was proved. Finally, metho trexate was effective. The patient became afebrile, and his skin lesio ns improved, leaving almost no scarring. This patient seems to have ha d specific clinical features that do not correspond with any of the kn own dermatitites. Clinical, histologic, and laboratory findings did no t uncover any etiologic factors.