Immunosuppressive states due to immunological sene- scence (1) or administration of immunosuppressants (2) occasionally cause Epstein-Barr virus (EBV)-induced B-cell lymphoproliferative disorders (LPDs). While methotrexate (MTX) is an anti-metabolite and anti-foliate agent for the treatment of cancers and autoimmune dis-

Journal Compilation © 2012 Acta Dermato-Venereologica. ISSN 0001-5555 Immunosuppressive states due to immunological senescence (1) or administration of immunosuppressants (2) occasionally cause Epstein-Barr virus (EBV)-induced B-cell lymphoproliferative disorders (LPDs). While methotrexate (MTX) is an anti-metabolite and anti-foliate agent for the treatment of cancers and autoimmune disorders, it can also potentiate tumourigenesis due to its immunosuppressive effect. EBV reactivation is observed in half of such cases, suggesting that EBV contributes to the pathogenesis (3, 4). A newly described clinicopathological entity, EBV-positive mucocutaneous ulcer (EMU), occurring in immunocompromised patients, has been proposed (4). We describe here a case of EMU presenting with large deep facial ulcers in association with MTX-LPDs, which has not previously been reported in literature.