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We report an unusual presentation of Cytomegalovirus (CMV) cutaneous perianal ulcerative lesion in a patient with severe immunosuppression. A 43-year-old male presented with perianal ulcer along with bleeding and pain while passing stools. On biopsy, the ulcer showed typical histopathological features of CMV infection with involvement of endothelial cells. The patient was treated with oral valganciclovir for CMV ulcer which showed significant improvement subsequently. After 2 weeks, antiretroviral therapy (ART) was reinitiated with Tenofovir disoproxil fumarate, Lamivudine, and Dolutegravir. A high index of suspicion should always be maintained for CMV cutaneous ulcers in individuals with advanced immunosuppression.
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Ginwala et al. (2024) studied this question.
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