title: Azathioprine-induced EBV-positive mucocutaneous ulcer.
abstract: Epstein-Barr virus (EBV)-positive mucocutaneous ulcer was recently described as a clinicopathologic entity occurring secondary to iatrogenic or age-related immune suppression. The histopathology of EBV-positive mucocutaneous ulcer reveals a polymorphous infiltrate including atypical large B-cells and Reed-Sternberg-like cells which are CD20-positive, CD30-positive and EBV-positive. The disorder follows an indolent and self-limited course. We report a case of EBV-positive mucocutaneous ulcer secondary to prolonged use of azathioprine for the treatment of pemphigoid and highlight the need for recognition of this disorder by dermatopathologists and dermatologists.
authors.affiliation: Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0592, USA.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: McGinness
authors.forename: Kerith E
authors.initials: KE
authors.lastname: Spicknall
authors.forename: Diya F
authors.initials: DF
authors.lastname: Mutasim
mesh_terms: D000368:Aged; D018951:Antigens, CD20 / Q000378:metabolism; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects*; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000139:chemically induced* / Q000473:pathology*; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D017730:Ki-1 Antigen / Q000378:metabolism; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000821:virology; D016539:Reed-Sternberg Cells / Q000378:metabolism / Q000473:pathology / Q000821:virology; D012883:Skin Ulcer / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology / Q000821:virology*
chemical_list: D018951:Antigens, CD20; D000964:Antimetabolites, Antineoplastic; D017730:Ki-1 Antigen; D001379:Azathioprine