Bright, Eosinophilic Intracytoplasmic Inclusion Bodies: A Rare Presentation of Acquired Epidermodysplasia Verruciformis with Widespread Human Papillomavirus Infection in a Transplant Recipient

This case study describes a 46-year-old Afro-Caribbean woman with poorly controlled type 1 diabetes mellitus who developed acquired epidermodysplasia verruciformis (EV) after a pancreas-kidney transplant. Initially suspected to have trichodysplasia spinulosa (TS), histological analysis revealed features consistent with EV, including unique eosinophilic intracytoplasmic inclusion bodies indicative of HPV-49 infection. This is a rare presentation, with only one other reported case worldwide, highlighting the unusual association of EV with HPV-49 in a post-transplant patient.