Epstein-Barr Virus-Associated Vesiculopapular Eruption on the Face of a Patient with Natural Killer T Cell Lymphoma

Abstract

Unlike typical hydroa vacciniforme (HV), Epstein-Barr virus (EBV)-associated HV-like eruption is more variable in its clinical manifestations. In some patients, progression to lymphoma or leukemia has been reported, which are characterized by the T-cell immunophenotype. Here, we report the first Korean case of EBV-associated vesiculopapular eruption on the face of a patient with natural killer (NK)/T cell lymphoma. A 32-year-old Korean man presented with a late adolescent-onset recurrent necrotic papulovesicles on his face. The patient was previously diagnosed with EBV-associated NK/T cell lymphoma of the oral cavity and also had childhood-onset hypersensitivity to mosquito bites. Biopsy of his facial skin showed EBV-associated vesiculopapular eruptions, though ultraviolet provocation did not reproduce the skin lesions. EBV viral load in his peripheral blood was detected but low. The patient was treated with systemic chemotherapy. The lymphoma went into remission, but the facial EBV-associated vesiculopapular eruption had a relapsing and remitting course.

Keywords: Epstein-Barr virus; Epstein-Barr virus-associated hydroa vacciniforme-like eruption; Epstein-Barr virus-associated vesiculopapular eruption; hydroa vacciniforme; natural killer T cell lymphoma.

Fig. 1. (A) Mild erythematous and edematous papulovesicular eruptions on the patient's face. (B) Microscopic findings of small to medium sized lymphocytic infiltration through dermis (H&E, ×100). (C) In situ hybridization. Epstein-Barr virus early RNA (EBER) positive lymphocytes are found in biopsy specimen (EBER, ×100).