Journal Mobile Options
Table of Contents
Vol. 226, No. 3, 2013
Issue release date: August 2013
Section title: Case Report
Dermatology 2013;226:212-216
(DOI:10.1159/000348709)

Chronic Active Epstein-Barr Virus Infection-Associated Hydroa Vacciniforme-Like Eruption and Behçet's-Like Orogenital Ulcers

Park B.M. · Ahn J.-S. · Lee J.B. · Won Y.H. · Yun S.J.
Departments of aDermatology and bHematology-Oncology, Chonnam National University Medical School, Gwangju, South Korea

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: 12/11/2012 8:39:13 AM
Accepted: 2/4/2013
Published online: 6/1/2013

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM

Abstract

The cutaneous manifestations of chronic active Epstein-Barr virus (EBV) infection can be diverse. Among them, hydroa vacciniforme-like eruption is one of the best-known features. Although rare, mucosal ulcers have been reported to be associated with EBV as a result of primary infection or immune suppression. We describe a 65-year-old female with recurrent necrotic papulovesicles on the face and both arms for 2 years. She also complained of recurrent oral and genital mucosal ulcers developing simultaneously with skin eruptions. They appeared periodically during the spring and summer and were triggered or aggravated by sun exposure. Skin biopsies from the face and genitalia showed identical findings with dense lymphocytic infiltrations. In addition, in situ hybridization revealed EBV-positive lymphoid cells in both specimens. To our knowledge, this is the first case of serologically and pathologically proven chronic active EBV infection presenting hydroa vacciniforme-like eruption and orogenital ulcers at the same time in one patient.


Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: 12/11/2012 8:39:13 AM
Accepted: 2/4/2013
Published online: 6/1/2013

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Cohen JI: Epstein-Barr virus infection. N Engl J Med 2000;343:481-492.
  2. Kimura H: Pathogenesis of chronic active Epstein-Barr virus infection: is this an infectious disease, lymphoproliferative disorder, or immunodeficiency? Rev Med Virol 2006;16:251-261.
  3. Iwatsuki K, Xu Z, Ohtsuka M, Kaneko F: Cutaneous lymphoproliferative disorders associated with Epstein-Barr virus infection: a clinical overview. J Dermatol Sci 2000;22:181-195.
  4. Iwatsuki K, Ohtsuka M, Harada H, Han G, Kaneko F: Clinicopathologic manifestations of Epstein-Barr virus-associated cutaneous lymphoproliferative disorders. Arch Dermatol 1997;133:1081-1086.
  5. Al-Rawahi GN, Dobson SR, Scheifele DW, Rassekh SR, Murphy JJ: Severe genital ulceration in an acute Epstein-Barr virus infection. Pediatr Infect Dis J 2011;30:176-178.
  6. Barnes CJ, Alio AB, Cunningham BB, Friedlander SF: Epstein-Barr virus-associated genital ulcers: an under-recognized disorder. Pediatr Dermatol 2007;24:130-134.
  7. Cheng SX, Chapman MS, Margesson LJ, Birenbaum D: Genital ulcers caused by Epstein-Barr virus. J Am Acad Dermatol 2004;51:824-826.
  8. Halvorsen JA, Breviq T, Aas T, Skar AG, Slevolden EM, Moi H: Genital ulcers as initial manifestation of Epstein-Barr virus infection: two new cases and a review of the literature. Acta Derm Venereol 2006;86:439-442.
  9. Lampert A, Assier-Bonnet H, Chevallier B, Clerici T, Saiag P: Lipschutz's genital ulceration: a manifestation of Epstein-Barr virus primary infection. Br J Dermatol 1996;135:663-665.
  10. Sardy M, Wollenberg A, Niedermeier A, Flaig MJ: Genital ulcers associated with Epstein-Barr virus infection (ulcus vulvae acutum). Acta Derm Venereol 2011;91:55-59.

    External Resources

  11. Dojcinov SD, Venkataraman G, Raffeld M, Pittaluga S, Jaffe ES: EBV positive mucocutaneous ulcer - a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol 2010;34:405-417.
  12. McGinness JL, Spicknall KE, Mutasim DF: Azathioprine-induced EBV-positive mucocutaneous ulcer. J Cutan Pathol 2012;39:377-381.
  13. Cho KH, Lee SH, Kim CW, Jeon YK, Kwon IH, Cho YJ, Lee SK, Suh DH, Chung JH, Yoon TY, Lee SJ: Epstein-Barr virus-associated lymphoproliferative lesions presenting as a hydroa vacciniforme-like eruption: an analysis of six cases. Br J Dermatol 2004;151:372-380.
  14. Xu Z, Lian S: Epstein-Barr virus-associated hydroa vacciniforme-like cutaneous lymphoma in seven Chinese children. Pediatr Dermatol 2010;27:463-469.
  15. Wu YH, Chen HC, Hsiao PF, Tu MI, Lin YC, Wang TY: Hydroa vacciniforme-like Epstein-Barr virus-associated monoclonal T-lymphoproliferative disorder in a child. Int J Dermatol 2007;46:1081-1086.
  16. Cho KH, Kim CW, Heo DS, Lee DS, Choi WW, Rim JH, Han WS: Epstein-Barr virus-associated peripheral T-cell lymphoma in adults with hydroa vacciniforme-like lesions. Clin Exp Dermatol 2001;26:242-247.
  17. Cho KH, Kim CW, Lee DY, Sohn SJ, Kim DW, Chung JH: An Epstein-Barr virus-associated lymphoproliferative lesion of the skin presenting as recurrent necrotic papulovesicles of the face. Br J Dermatol 1996;134:791-796.
  18. Ruiz-Maldonado R, Parrilla FM, Orozco-Covarrubias ML, Ridaura C, Tamayo Sanchez L, Duran McKinster C: Edematous, scarring vasculitic panniculitis: a new multisystemic disease with malignant potential. J Am Acad Dermatol 1995;32:37-44.
  19. Magana M, Sangueza P, Gil-Beristain J, et al: Angiocentric cutaneous T-cell lymphoma of childhood (hydroa-like lymphoma): a distinctive type of cutaneous T-cell lymphoma. J Am Acad Dermatol 1998;38:574-579.
  20. Iwatsuki K, Xu Z, Takata M, et al: The association of latent Epstein-Barr virus infection with hydroa vacciniforme. Br J Dermatol 1999;140:715-721.
  21. Nishizawa A, Satoh T, Takayama K, Yokozeki H: Hydroa vacciniforme with mucosal involvement and recalcitrant periodontitis and multiple virus re-activators after sun-exposure. Acta Derm Venereol 2010;90:498-501.
  22. Sunohara A, Mizuno N, Sakai M, Kawabe Y, Sakakibara S: Action spectrum for UV erythema and reproduction of the skin lesions in hydroa vacciniforme. Photodermatology 1988;5:139-145.

    External Resources

  23. Heo EP, Park SH, Kim TH: Artificial reproduction of atypical hydroa vacciniforme caused by latent Epstein-Barr virus infection. Int J Dermatol 2003;42:476-479.
  24. Schwarz T: Photoimmunosuppression. Photodermatol Photoimmunol Photomed 2002;18:141-145.
  25. Sun A, Chang JG, Chu CT, Liu BY, Yuan JH, Chiang CP: Preliminary evidence for an association of Epstein-Barr virus with pre-ulcerative oral lesions in patients with recurrent aphthous ulcers or Behçet's disease. J Oral Pathol Med 1998;27:168-175.
  26. Hooks JJ: Possibility of a viral etiology in recurrent aphthous ulcers and Behçet's syndrome. J Oral Pathol 1978;7:353-364.