Trichodysplasia spinulosa--a rare complication in immunosuppressed patients.

Abstract

Immunosuppression is necessary in a large number of conditions to modify immune responses and control disease severity. It is a vital part of treatment regimes following organ and bone marrow transplants. However, the use of immunosuppressive drugs has been shown to cause infections with common and unusual pathogens. We present the case of a 5-year-old female heart transplant recipient. Nine months after the transplant, she developed a tender acneiform eruption on her face consisting of numerous small yellowish to pink papules and pustules. Many of the lesions had a central, firm, small spinulous excrescence or a central dell. Histopathology demonstrated abnormal maturation of the hair follicles, nucleated eosinophilic cells with trichohyalin granules. The clinical presentation and histological features were in keeping with trichodysplasia spinulosa, a rare complication in immunosuppressed subjects. Treatment trials included reduction of immunosuppression combined with topical and oral retinoids, topical acyclovir, and oral valganciclovir with limited success.

• Authors: Agnes Schwieger-Briel, Alexandra Balma-Mena, BoYee Ngan, Anne Dipchand, Elena Pope
• Journal: Pediatric dermatology (Pediatr Dermatol) Vol. 27 Issue 5 Pg. 509-13 ( 2010) ISSN: 1525-1470 [Electronic] United States
• PMID: 20796236 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2010 Wiley Periodicals, Inc.

Chemical References

• Immunosuppressive Agents

Topics

• Biopsy
• Child, Preschool
• Drug Eruptions (etiology, pathology)
• Facial Dermatoses (chemically induced, pathology)
• Female
• Graft Rejection (drug therapy)
• Hair Diseases (chemically induced, pathology)
• Heart Transplantation
• Humans
• Immunocompromised Host
• Immunosuppressive Agents (adverse effects)