EBV-positive mucocutaneous ulcer - Only in immunosuppressed patients?

We report the case of a 42-year-old male without a previous medical history who presented with hematochezia, tenesmus, and weight loss over two months. An ulcerated lesion located on the pectineal line, covering the entire circumference, was identified by colonoscopy. Histologically, there was a lymphoplasmacytic infiltrate and histiocytes with atypical Hodgkin-like lymphoid cells, and the immunohistochemistry tested positive for EBV. Random biopsies of the colorectal mucosa were normal. Thus, the patient was diagnosed with Epstein-Barr virus mucocutaneous ulcer (EBVMCU).