EPSTEIN-BARR VIRUS-RELATED PRIMARY CUTANEOUS AMYLOIDOSIS - SUCCESSFULTREATMENT WITH ACYCLOVIR AND INTERFERON-ALPHA

Cutaneous lesions related to chronic active Epstein-Barr virus (EBV) i nfection have been rarely documented in immunocompetent patients. A 30 -year-old woman, fulfilling the diagnostic criteria for the chronic fa tigue syndrome, had a 10-year history of pruritic brownish macules and papules on her chest and back. Her EBV serology was abnormal; the EBV genome was present in the epidermis of lesions, in oral secretions, a nd in peripheral mononuclear cells (PMC). Her blood lymphocytes sponta neously outgrew in culture. Histology revealed deposits of amyloid in the papillary dermis. Treatment with acyclovir and interferon-alpha ra pidly improved her condition, stopped the lymphocyte outgrowth in cult ure, and reduced the EBV DNA content in oral secretions and in PMC, Th ese data support an endogenous reactivation of EBV infection and sugge st a causal relationship with primary amyloidosis.