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Clinicopathologic Manifestations of Epstein-Barr Virus—Associated Cutaneous Lymphoproliferative Disorders

Keiji Iwatsuki, MD; Mikio Ohtsuka, MD; Hiroshi Harada, MD; Gangwen Han, MD; Fumio Kaneko, MD
Arch Dermatol. 1997;133(9):1081-1086. doi:10.1001/archderm.1997.03890450023003.
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Objective:  To elucidate clinicopathologic manifestations of cutaneous lymphoproliferative disorders associated with Epstein-Barr virus (EBV) infection.

Design:  Retrospective survey of case series.

Setting:  University hospital medical center.

Patients:  Sixty-five patients with cutaneous lymphomas and related disorders.

Main Outcome Measures:  Detection of EBV genes and EBV-encoded small nuclear RNAs.

Results:  Evidence of latent EBV infection was demonstrated in 15 patients: 3 had malignant lymphoma with clinical features mimicking cytophagic histiocytic panniculitis, 6 had facial vesiculopapular eruptions mimicking hydroa vacciniforme, 4 had angiocentric lymphoma, I had histiocytoid lymphoma associated with hemophagocytosis, and I had plasmacytoma. Hypersensitivity to mosquito bites was noted in a patient with hydroa vacciniforme-like eruptions and another with histiocytoid lymphoma. Angiocentric infiltration of atypical lymphoid cells was a common histological feature in the patients with hydroa vacciniforme-like eruptions and angiocentric lymphoma. No evidence of EBV infection was apparent in 19 patients with mycosis fungoides or Sézary syndrome, 7 with adult T-cell leukemia or lymphoma, 3 with lymphomatoid papulosis (type A), and 2 with lymphocytoma cutis.

Conclusion:  Patients with EBV-associated cutaneous lymphoproliferative disorders present with unique and diagnostic clinicopathologic features distinct from those of mycosis fungoides or Sézary syndrome.Arch Dermatol. 1997;133:1081-1086

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