Recurrent mucocutaneous lymphocytic infiltration possibly associated with Epstein-Barr virus infection

A 32-year-old man had a history of recurrent but self-healing necrotizing nodules on the face and oral mucosa. Histologically the lesion was composed of necrotizing foci surrounded with dense CD8+ T lymphocytic infiltration in the dermis. Laboratory examination showed marked blood CD8+ T lymphocytosis with a reversed ratio of CD4+/CD8+ of 0.11. Except for a very high titer of antibodies against Epstein-Barr-virus-associated antigens, no signs of infection were observed.