Clinical and laboratory manifestations of EBV-driven LHES. (A) Skin lesions before (left and center panels) and during (right panel) prednisone therapy. (B) Intracellular production of IL-4, IL-5, IL-13, and IFN-γ by viable CD3⁺CD4⁺ Vβ5.1-positive (top panels) and -negative (bottom panels) T cells. (C) Absolute eosinophil count and EBV DNA in the blood as a function of time. P, prednisone; IFN, interferon-α; V/G, vorinostat/ganciclovir. (D) Paraffin-embedded sections of a skin biopsy stained with hematoxylin and eosin (top left panel) showing dense eosinophilic infiltrate in the upper dermis, antibody to CD3 (bottom left panel), antibody to CD20 (top right panel) and in situ hybridization for EBER (bottom right panel). Magnification, ×400. (E) EBV DNA localization by fluorescence in situ hybridization showing EBV DNA in the nucleus of EBV-positive transformed B cells and in the patient’s Vβ5.1-positive T cells, but not in EBV-negative B cells. (F) Quantitative EBV DNA PCR in peripheral blood from normal volunteers and patients with LHES. Symbols represent individual subject data. ○, The value for the subject with EBV-driven LHES.