Madarosis And Facial Keratinaceous Spines
February 2023
in “
JAAD case reports
”
New to Rapamycin? There is a guide in the encyclopedia. Read the guide → 
Studysummary This case report describes a patient who developed Trichodysplasia spinulosa, a folliculocentric viral infection, after heart transplantation, and experienced improvement in her skin condition following modulation of immunosuppressive therapy and application of topical cidofovir. Our plain-language summary of this paper — not a Tressless recommendation.
A 66-year-old woman with a history of breast cancer and heart transplant developed a papular eruption with white keratinaceous spikes on her face and concurrent loss of eyebrows and eyelashes after transitioning to sirolimus. Histologic examination confirmed Trichodysplasia spinulosa (T. spinulosa) associated with T. spinulosa–associated polyomavirus (TSPyV). The recommended treatment involved reducing immunosuppression, which led to modest improvement, followed by the use of cidofovir 3% cream, resulting in further improvement. If untreated, T. spinulosa can lead to facial scarring and leonine facies.
