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Disseminated Cutaneous Cytomegalovirus Infection Following Total Body Electron Beam Irradiation for Mycosis Fungoides

Julie K. Kim, MD1; Adeel Ahmad, MD2; M. Angelica Selim, MD3,4; Elise A. Olsen, MD3,5; Adela R. Cardones, MD3,6
[+] Author Affiliations
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
2Eastern Pathology and Dermatology Associates and Surgery Center, Beckley, West Virginia
3Department of Dermatology, Duke University Medical Center, Durham, North Carolina
4Department of Pathology, Duke University Medical Center, Durham, North Carolina
5Department of Medicine, Duke University Medical Center, Durham, North Carolina
6Durham VA Medical Center, Durham, North Carolina
JAMA Dermatol. 2015;151(12):1380-1381. doi:10.1001/jamadermatol.2015.2233.
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This case report describes the occurrence of disseminated cutaneous cytomegalovirus infection in an immunocompromised patient following total body electron beam irradiation for mycosis fungoides.

Cutaneous cytomegalovirus (CMV) infections are rare and are often associated with poor prognosis from an underlying malignant condition or immunosuppression.1,2 We report a unique case of disseminated cutaneous CMV infection and CMV viremia following total body electron beam (TBEB) irradiation.

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Figure 1.
Clinical Presentation of Cutaneous Cytomegalovirus Infection

Shallow, punched-out, oval ulcerations are seen scattered diffusely on the trunk and extremities.

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Figure 2.
Pathologic Findings From Cutaneous Cytomegalovirus (CMV) Ulcer Specimens

In the primary image, scattered endothelial cells in small dermal vessels demonstrate large eosinophilic intranuclear inclusions surrounded by a clear halo (arrowhead) (hematoxylin-eosin, original magnification ×40). The inset highlights several endothelial cells and fibroblasts (CMV immunohistochemical stain, original magnification ×40).

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