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Review
, 93 (6), 786-799

Epstein-Barr Virus and Skin

Affiliations
Review

Epstein-Barr Virus and Skin

Martin Sangueza-Acosta et al. An Bras Dermatol.

Abstract

Epstein-Barr virus is a DNA virus infecting human beings and could affect 90% of human population. It is crucial to take in account that in Latin America, unlike what happens in developed countries, the exposure to the virus is very early and therefore people have a much longer interaction with the virus. The virus is related to many diseases, mainly the oncological ones, and when the onset is in cutaneous tissue, it can present many clinical variants, as well acute as chronic ones. Among the acute ones are infectious mononucleosis rash and Lipschutz ulcers; the chronic presentations are hypersensivity to mosquito bites, hydroa vacciniforme, hydroa vacciniforme-like lymphoma, its atypical variants and finally nasal and extra-nasal NK/T-cell lymphoma. Although they are not frequent conditions, it is crucial for the dermatologist to know them in order to achieve a correct diagnosis.

Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1
A - Multiple Lipschutz ulcers, on both labia, as kissing ulcers, sometimes can be very large. B - Histological aspect showing dense predominantly perivascular lymphocytic infiltrate, also affecting the wall of blood vessels and sebaceous glands (Hematoxylin & eosin, x2 and x40)
Figure 2
Figure 2
A - Abnormal reaction to mosquito bite. They are infiltrated, painful lesions, and some ulcerated. B - Histological aspect of the insect bite site showing a dense mixed infiltrate, with presence of eosinophils and atypical lymphoid cells (Hematoxylin & eosin, x2 and x40)
Figure 3
Figure 3
A - Clinical aspect of hydroa vacciniforme, with ulcerated lesions leaving depressed scars. In chronic forms, recurrences can occur. B - Histopathology of an acute lesion showing ulceration and a mixed type infiltrate, granulation tissue and infiltrate of large lymphocytes with epithelial and adnexal tropism (Hematoxylin & eosin, x2 and x40)
Figure 4
Figure 4
A - Clinical aspect of hydroa vacciniforme-type lymphoma: they are infiltrated, ulcerated and edematous lesions. B - Histologically, a nodular infiltrate of atypical cells of medium and large size is observed. The cells are positive for CD3, CD8, and EBV by in situ hybridization (Hematoxylin & eosin, x2 and x40)
Figure 5
Figure 5
A - Atypical presentation forms of hydroa-type lymphoma on eyelids and lips; they present swollen, with ulceration and necrotic areas. B - The infiltrate is dense and diffuse with extension to the hypodermis. At higher magnification, it is identified the presence of atypical cells infiltrating the subcutaneous and muscular tissues (Hematoxylin & eosin, x2 and x40)
Figure 6
Figure 6
A - Presentation forms of the extranodal centrofacial NK lymphoma as an exophytic tumor mass, other times with destruction of the septum and more frequently in elderly people, it is observed as a tumoration on the palate and finally as a destructive lesion of the nasal septum. B - Histologically a dense inflammatory infiltrate is observed, composed by atypical cells arranged in mantle pattern. It is important to stain CD56 and TIA-1 (Hematoxylin & eosin, x2 and x40)

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