By Gary M. White, MD

Cytomegalovirus (CMV) is a common virus that usually does not cause disease. However, in immunocompromised hosts, it can cause a variety of skin lesions, including ulcers.


Individual case reports have documented a wide variety of skin lesions in both normal and compromised hosts including maculopapular, urticarial, and scarlitiniform eruptions, crusted papules, nodules, and verrucous, papulopustular or vesicobullous lesions. The classic presentation however of CMV lesions in immunocompromised patients (e.g. AIDS) is an ulcerative lesions, usually of the oral mucosa, but also of the genital and perineal region. One case of an HIV-positive infant with scalp ulcers was reported [Peds Derm 2014;31;729]. CMV may reactivate win the setting of acute Graft vs. Host disease.

Possible CMV Presentations



Referral to an infectious disease specialist is in order. For a mononucleosis-like syndrome in a an immunocompetent host, supportive care only is needed. For immunocompromised patients, ganciclovir, valganciclovir and foscarnet for resistant strains have been used.


A 23-year-old man with common variable immunodeficiency and a large eroded plaque on the right cheek. British J Dermatology Jan 2014

Heart transplant patient with an ulcer on the leg. JAMA Derm 2015;151;661


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