Radiotherapy for Epstein-Barr Virus-Positive Mucocutaneous Ulcer at the Lower Leg Skin: A Case Report

Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a rare lymphoproliferation and a relatively benign condition. Although the condition can be cured without treatment, some cases require chemotherapy, resection, or radiotherapy. However, there are no established standards regarding the dose and schedule of radiation therapy. We present the case of a 44-year-old female with a history of living donor kidney transplantation who developed EBVMCU in the right lower leg after 23 years. She did not improve with conservative therapy and was treated with low-dose radiotherapy (4 Gy in two fractions) to the EBVMCU on the lower leg skin. The patient achieved complete control after one year without toxic effects. This case report provides evidence that low-dose radiotherapy is a potentially effective treatment for EBVMCU in patients who do not improve with observation or by decreasing immunosuppressive therapy.