Azathioprine-induced EBV-positive mucocutaneous ulcer

Area of Science:

• Immunology
• Dermatopathology

Background:

• Epstein-Barr virus (EBV)-positive mucocutaneous ulcer is a recently identified clinicopathologic entity.
• It arises secondary to iatrogenic or age-related immune suppression.

Observation:

• This report details a case of EBV-positive mucocutaneous ulcer.
• The ulcer developed in a patient undergoing prolonged azathioprine therapy for pemphigoid.

Findings:

• Histopathology shows a polymorphous infiltrate with atypical large B-cells and Reed-Sternberg-like cells.
• These cells are characteristically CD20-positive, CD30-positive, and EBV-positive.
• The condition exhibits an indolent and self-limited clinical course.

Implications:

• This case underscores the importance of recognizing EBV-positive mucocutaneous ulcer in clinical practice.
• Dermatopathologists and dermatologists should be aware of this entity, especially in immunosuppressed patients.
• Prompt diagnosis and awareness can aid in managing this condition effectively.