Hydroa Vacciniforme-Like Lymphoproliferative Disorder in the Elderly: A Case Report and Diagnostic Challenges.

BACKGROUND

Hydroa vacciniforme-like lymphoproliferative disorder is a rare Epstein-Barr virus -associated T/NK cell proliferation predominantly.

CASE PRESENTATION: A 72-year-old female presented with persistent skin lesions and high fever. The atypical distribution of lesions, along with the spontaneous regression of some of them, and the positive Staphylococcus aureus culture, initially made the diagnostic process complicated. However, skin biopsies revealed CD3+CD8+ T-cell infiltration, partial loss of CD5 expression, a high proliferative index, and positive Epstein-Barr virus-encoded RNA in situ hybridization. Reactive lymph node hyperplasia ruled out systemic lymphoma, thus supporting the diagnosis of HVLPD.

CONCLUSION

HVLPD can present in the elderly with lesions in unexposed areas. Diagnostic challenges require accounting for infectious confounders.