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While cutaneous manifestations of systemic CMV infection are rare, dermatologic manifestations of CMV are increasingly reported with a wide morphologic spectrum clinically. Three male patients, with untreated human immunodeficiency virus (HIV), penile lichenoid dermatitis treated with long\u2010term topical and intralesional corticosteroids, and metastatic Merkel cell carcinoma on immune checkpoint inhibitor therapy, each presented with isolated cutaneous ulcers. The ulcers were located on the perianal skin, glans of the penis, and distal thumb. In each case, nonspecific histopathologic features were seen. However, very rare dermal cytomegalic cells with nuclear and cytoplasmic inclusions were present and highlighted with an immunohistochemical stain for CMV. Isolated ulcers due to CMV infection may occur in the setting of systemic or localized immunosuppression. A high index of suspicion is needed upon histopathologic evaluation, as few cytomegalic cells may be present and accurate diagnosis is crucial for prompt and appropriate clinical management.<\/jats:p>","DOI":"10.1111\/cup.14608","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T05:49:56Z","timestamp":1713937796000},"page":"565-571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unusual isolated cytomegalovirus cutaneous infections: A subtle histopathologic diagnosis with review of the literature"],"prefix":"10.1111","volume":"51","author":[{"given":"Emily M.","family":"Hartsough","sequence":"first","affiliation":[{"name":"Dermatopathology Unit, Department of Pathology Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts 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