Age‐related Epstein–Barr virus‐positive mucocutaneous ulcer: a case report

Abstract

Key Clinical MessageThe oral manifestations of EBV-positive mucocutaneous ulcers have a worrisome clinical appearance but relatively benign clinical course, responding well to conservative treatment. Elderly patients who develop an unexplained, persistent ulcer of the oral mucosa should have the lesion examined for EBV.

Comparison of Epstein–Barr virus‐positive mucocutaneous ulcer associated with treated lymphoma or methotrexate in Japan

“…There were some differences in the predisposing factors in the EBVMCU patients in Western versus Eastern countries. Specifically, EBVMCU was associated with iatrogenic immunosuppressive drugs in 38% of Western patients, with age‐related immunosenescence in 36%, and with transplantation and other factors in 26% . In Eastern countries, EBVMCU was reported in the setting of iatrogenic immunosuppressive drug use for autoimmune disease in 59% of patients, post‐chemotherapy in 36%, and in association with other factors in 5% .…”

Epstein–Barr Virus-Positive Mucocutaneous Ulcer: A Unique and Curious Disease Entity

“…In 186 EBVMCU cases [ 5 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ], during the follow-up periods (1–180 months), spontaneous improvement of the ulcers was noted in eight patients, and 126 patients had either complete or partial remission after discontinuation or dose reduction of immunosuppressants, chemotherapy, or radiotherapy. While eight patients experienced recurrence [ 15 , …”

A rare case of Epstein-Barr virus mucocutaneous ulcer of the colon

“…In some case reports and case series, observation in conjunction with stopping the immunosuppressive therapy was sufficient for treatment of the EBVMCU,1 5 6 while some cases were treated with radiotherapy, chemotherapy or combination of both 1 4 6. In a case report by Magalhaes et al , an oral EBVMCU in a patient with diabetes was treated conservatively and a repeated biopsy after 2 months showed a healed ulcer; follow-up after a 12-month period showed that the patient remained free of recurrence 4. On the other hand, Moran et al described a case of EBVMCU of the colon in a patient with Crohn’s disease treated with infliximab and methotrexate, even after stopping the immunosuppressive agents the ulcer failed to regress and progressed to Hodgkin’s lymphoma after 18 months which shows the gloomy side of the EBVMCU 5…”