PMC3546098_01
Gross appearance of the skin lesion. (A) Erythematous swelling with a central bulla. (B) Another bullous skin lesion developed 1 yr after diagnosis of HMB. (C) Eschar formation from a bulla at a mosquito bite site.
jkms-28-164-g001.jpg
PMC3546098_01_jkms-28-164-g001.jpg
F1
On physical examinations at admission, erythematous swelling with a central bulla was found on his right ankle (Fig. 1A). During the next summer season, he was admitted twice because of severe skin reactions and fever after mosquito bite (Fig. 1B, C).
Pathologic findings of the skin lesion. (A: H&E, x 100, B: x 400). Histopathologic examination of the skin biopsy specimen showed intraepidermal vesicles with interstitial and perivascular infiltration of lymphocytes, neutrophils, eosinophils and histiocytes. (C) In situ hybridization analysis for EBER was positive (dark brown color, x 400). (D) Immunohistochemical staining with CD56 was negative (x 400).
jkms-28-164-g002.jpg
PMC3546098_01_jkms-28-164-g002.jpg
F2
Skin biopsy from the lesion showed intraepidermal vesicles with interstitial and perivascular infiltration of lymphocytes, neutrophils, eosinophils and histiocytes (Fig. 2A, B). EBV encoded RNA (EBER) in situ hybridization was positive (Fig. 2C) and immunohistochemical staining with NK cell marker (CD56) of biopsy specimen was negative (Fig. 2D).