Hydroa vacciniforme-like cutaneous T-cell lymphoma

Area of Science:

• Dermatology
• Virology
• Oncology

Background:

• Recurrent skin lesions can manifest in adolescents with underlying viral infections.
• Epstein-Barr virus (EBV) is implicated in various lymphoid and epithelial cell disorders.
• Cutaneous manifestations of EBV infection require accurate histopathological and molecular diagnosis.

Purpose of the Study:

• To present a case of a 14-year-old girl with a 6-year history of recurrent skin lesions.
• To investigate the potential link between Epstein-Barr virus and the observed dermatological condition.
• To document the diagnostic process and treatment outcome.

Main Methods:

• Clinical examination and patient history.
• Histopathological analysis of skin biopsy.
• Immunohistochemistry for T-cell markers and B-cell markers.
• In situ hybridization for Epstein-Barr virus-encoded small nonpolyadenylated RNA (EBER-1).

Main Results:

• Positive Epstein-Barr virus (EBV)-IgM.
• Histopathology revealed lymphocyte invasion in subcutaneous adipose tissue around blood vessels.
• Immunohistochemistry confirmed a T-cell phenotype (CD3+, CD4+, CD5+, CD8+, TIA-1+, GrB+) with absence of CD56 and L26 (B-cell marker).
• In situ hybridization was positive for EBER-1, indicating active EBV infection within the lesional cells.

Conclusions:

• The findings suggest a diagnosis of EBV-associated cutaneous T-cell lymphoma.
• The patient demonstrated significant clinical improvement following treatment with acyclovir and interferon-alpha (IFN-α).
• This case underscores the importance of considering EBV in the differential diagnosis of recurrent skin lesions, especially in pediatric patients.