Skin-nontumor / Clinical dermatology
Infectious disorders
CMV (cytomegalovirus)

Author: Mowafak Hamodat, MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 20 May 2016, last major update July 2011

Copyright: (c) 2002-2016,, Inc.

PubMed Search: CMV [title] AND Cytomegalovirus [title]

Cite this page: CMV (cytomegalovirus). website. Accessed December 18th, 2017.
Definition / general
  • CMV belongs to the subgroup of beta herpesviruses
  • Like other members of the family Herpesviridae, CMV produces primary infections, latent infections and reinfections, although its site of latency is not known
Clinical features
  • 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)
  • Ganciclovir, a guanosine analogue that selectively inhibits CMV DNA polymerase, may be used
Microscopic (histologic) description
  • 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
Microscopic (histologic) images

Images hosted on other servers:

Classic owl's eye inclusions

CMV immunostain

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