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Skin-nontumor

Infectious disorders

CMV (cytomegalovirus)


Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns (Canada) (see Reviewers page)
Revised: 24 August 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● CMV belongs to the subgroup of beta herpesviruses

Epidemiology
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● Like other members of the family Herpesviridae, CMV produces primary infections, latent infections and reinfections, although its site of latency is not known

Treatment
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● Ganciclovir, a guanosine analogue that selectively inhibits CMV DNA polymerase, may be used

Clinical description
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● Post-ampicillin maculopapular eruption is most common clinical presentation
● Presents with urticaria, vesiculobullous lesions, pustular lesions and ulceration (including genital ulcers); also keratotic lesions, diaper dermatitis and even epidermolysis
● Rarely associated with erythema multiforme (J Cutan Med Surg 2011;15:115)

Clinical images
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Various images

Micro description
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● Non-specific dermal infiltrate
● Characteristic changes are enlarged endothelial cells in small dermal vessels; nuclei contain large, eosinophilic inclusions surrounded by a clear halo; cytomegalic changes without nuclear inclusions have been reported
● May also be prominent neutrophilic infiltration of involved vessel walls, although an unequivocal leukocytoclastic vasculitis is quite rare
● Fibrocytes, macrophages and rarely ductal epithelial cells may harbor viral inclusions

Micro images
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Classic owl's eye inclusions


CMV immunostain

Positive stains
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● Monoclonal antibodies to CMV can confirm diagnosis in cases with unusual histopathological changes
● PCR-based methods are also available

End of Skin-nontumor > Infectious disorders > CMV (cytomegalovirus)


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