title: Cytomegalovirus Scrotal Ulcer in a Renal Transplant Patient.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is a highly prevalent herpesvirus that can present with cutaneous disease in immunocompromised individuals. This may reflect systemic involvement, which is associated with significant morbidity and mortality.
  
  
  OBJECTIVE
  To report a case of cutaneous CMV in an immunocompromised patient and to discuss the differential diagnosis of genital ulcers.
  
  
  METHODS
  A medical chart review was conducted on a patient who presented with a scrotal ulcer after renal transplantation. A review of the literature on cutaneous CMV disease was also completed.
  
  
  RESULTS
  Biopsy of the scrotal ulcer revealed classic findings of CMV disease. The patient also developed CMV viremia. Treatment with valganciclovir resolved his scrotal ulcer and viremia.
  
  
  CONCLUSIONS
  The differential diagnosis for genital ulcers is broad, especially in the immunocompromised patient. Cutaneous CMV disease should be ruled out with biopsy and immunohistochemical examination in immunocompromised patients, as it may reflect systemic involvement and significantly affect patient care.
authors.affiliation: Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada rpinca@alumni.ubc.ca.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Pinca
authors.affiliation: Department of Pathology and Laboratory Medicine and Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Richard I
authors.initials: RI
authors.lastname: Crawford
authors.affiliation: Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Sheila
authors.initials: S
authors.lastname: Au
mesh_terms: D000368:Aged; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D012611:Scrotum; D012883:Skin Ulcer / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*
keywords: cytomegalovirus (CMV); genital ulcer; herpes simplex virus (HSV); human immunodeficiency virus (HIV); immunocompromise; infectious disease; renal transplant