Rebeca Pinca1, Richard I Crawford2, Sheila Au3. 1. Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada rpinca@alumni.ubc.ca. 2. Department of Pathology and Laboratory Medicine and Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 3. Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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. CONCLUSION: 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.
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. CONCLUSION: 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.