Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress.
"People believe that it is common to have a chronic mono infection that can cause problems for years. This is really not the case," said Hymes. EBV is a viral illness in the same family as herpes and varicella (chickenpox). Like those other members of the herpes virus family, the virus can stick around in your body, Hymes explained. However, the virus is dormant and only very rarely reactivates, usually in times of stress. "Chronic active Epstein-Barr infection is something we really only see in people with immune problems — transplant patients, HIV patients, or people born missing a part of their immune system or immune function," said Hymes. Lab testing can detect chronic presence of the virus and can rule it out, so it is easily diagnosed.