Cytomegalovirus‐induced cutaneous microangiopathy manifesting as lower limb ischemia in a human immunodeficiency virus‐infected patient

Abstract

Cutaneous infections by cytomegalovirus (CMV) are rare and often difficult to diagnose both clinically and histopathologically. A wide range of different clinical manifestations have been described in the literature, especially in immunosuppressed patients. CMV-induced thrombosis has also been reported in these patients, and various mechanisms have been proposed to explain the role of CMV in the thrombotic process, including direct damage of the endothelial cells, activation of coagulation factors and inducing the production of antiphospholipid antibodies. We present the case of a human immunodeficiency virus (HIV)-infected woman who developed distal ischemic lesions of the lower extremities during a generalized CMV infection. We discuss the role of CMV and antiphospholipid antibodies in the pathogenesis of thrombosis in immunosuppressed patients.

Sudden and transient livedo reticularis as a manifestation of mononucleosis‐like disease by cytomegalovirus

“…Various diseases may cause this condition, including circulatory organ disease, collagen disease, vasculitis, leukaemia and infectious diseases. Although CMV infection is reported to induce peripheral vasculitis and distal ischaemic necrosis, 1,2 other vascular disorders have not been reported. We report a case of CMV‐related LR with spontaneous regression.…”

“…Various mechanisms have been proposed to explain the role of CMV in inducing ischaemic or thrombotic features, including direct damage to endothelial cells, 1,2 activation of coagulation factors 1,2 and induction of antiphospholipid antibodies 1 . However, the exact mechanisms remain to be elucidated.…”

“…Various mechanisms have been proposed to explain the role of CMV in inducing ischaemic or thrombotic features, including direct damage to endothelial cells, 1,2 activation of coagulation factors 1,2 and induction of antiphospholipid antibodies. 1 However, the exact mechanisms remain to be elucidated. We initially suspected that our patient had leukaemia because of a high fever, skin symptoms, and the presence of atypical lymphocytes and lymphoblasts.…”