The drawing, depicting a woman’s breasts and a “Donald” signature in the place of pubic hair, surrounded several lines of typewritten text, according to the newspaper, which reviewed the letter.

It concluded with the line: “Happy Birthday — and may every day be another wonderful secret.”

Trump in an interview with the Journal on Tuesday denied that he wrote the letter or drew the picture and threatened to sue the newspaper if it published the story.

“I never wrote a picture in my life. I don’t draw pictures of women,” he said, according to the Journal.

“It’s not my language. It’s not my words.”

The White House did not immediately respond to CNN’s request for comment.

But the Wall Street Journal report is likely to further fuel scrutiny of Trump’s handling of a Justice Department review of the Epstein case that has roiled his MAGA base and consumed the White House for several days.

Epstein, a financier who socialised with a range of politicians and other powerful figures, was charged in 2019 with sex trafficking minors in Florida and New York.

He was later found dead in his jail cell.

Medical examiners ruled the death a suicide, but the circumstances have since spawned an array of conspiracy theories.

In a memo last week, the Justice Department said Epstein did indeed die by suicide and that there was no Epstein “client list” and announced it wouldn’t release any more documents related to the case, infuriating an influential contingent of Trump supporters who believed the administration would make all of the Epstein files public.

Trump has since angrily dismissed the backlash, accusing his supporters of falling for a “hoax” by fixating on the case.

He urged Republicans to drop the issue altogether.

“Their new SCAM is what we will forever call the Jeffrey Epstein Hoax, and my PAST supporters have bought into this ‘bullshit,’ hook, line, and sinker,” Trump posted on Truth Social on Wednesday.

According to the Wall Street Journal, the letter bearing Trump’s name was included in a birthday album assembled by Ghislaine Maxwell, a close Epstein associate who was convicted of child sex trafficking in connection with Epstein.

She collected the letters from Trump and dozens of others for Epstein’s 50th birthday, the Journal reported.

The album was later part of the documents examined by Justice Department officials who investigated Epstein several years ago, according to the newspaper.