A potential role for cytomegalovirus in a facial ulcer in a renal transplant recipient

Abstract

Cytomegalovirus infection (CMV) is a well-known consequence of immunosuppression and one of the expected pathogens in recipients of solid organs such as renal transplant recipients (RTRs). Infection by CMV in immunocompromised settings can be life-threatening since many organs are involved and affected. Skin involvement has been rarely reported. In this report, we present a highly immunosuppressed RTR with CMV infection manifested as ulcerative skin lesions on the face, along with allograft dysfunction diagnosed by biopsy of the skin and the renal allograft, in addition to the presence of viral DNA in the tissue and antigenemia, which resolved following antiviral treatment. To the best of our knowledge, this is the first report in the literature of facial skin involvement induced by CMV in an RTR. This report emphasizes the value of early biopsy in RTRs with skin lesions and highlights CMV infection as a possible etiology.

Cytomegalovirus‐induced oral ulcers: A case report and literature review

“…Cytomegalovirus infection is manifested by nonspecific symptoms such as fever, asthenia, and more rarely by dermatological involvement, of which ulceration is one of the main manifestations 1,12 . In the case of mucosal damage, it presents a “die‐cut” appearance with well‐defined edges and extending deep in the tissue 13 .…”

“…Cytomegalovirus infection is manifested by nonspecific symptoms such as fever, asthenia, and more rarely by dermatological involvement, of which ulceration is one of the main manifestations. 1 , 12 In the case of mucosal damage, it presents a “die‐cut” appearance with well‐defined edges and extending deep in the tissue. 13 CMV‐induced oral ulcers are uncommon entities mostly found in patients with a high risk of infection, whether a primary infection or the reactivation of a latent virus.…”

“…Several authors have investigated the association of SLE with concomitant CMV infection, which occurs in approximately 10% of patients with SLE and may take the form of CMV skin ulcerations. 3 , 12 , 15 , 16 However, descriptions of cases of oral CMV ulcerations in SLE patients are very rare in the scientific literature (Table 1 ). One paper has reported a case of CMV infected oral ulcers in a woman with SLE, with no distinguishing clinical features.…”