An Eruption of Numerous Spiny Papules in a Pediatric Transplant Patient
December 2020
in “
American Journal of Transplantation
”
Studysummary This article discusses a journal-based CME activity on rare viral skin eruptions in pediatric transplant patients and reports no new clinical results; it aims to improve physicians' knowledge and treatment of this condition. Our plain-language summary of this paper — not a Tressless recommendation.
An 8-year-old African American female, who had undergone a renal transplant, presented with numerous tiny, white folliculocentric papules and spicules on her face, along with alopecia of the eyebrows and eyelashes. The patient was on a stable immunosuppressive regimen and had a history of antibody-mediated rejection treated with methylprednisolone and rituximab. A biopsy revealed abnormal eosinophilic inclusions in the hair follicle's inner root sheath, suggesting a diagnosis of virus-associated trichodysplasia spinulosa, linked to the trichodysplasia spinulosa–associated polyomavirus. After appropriate treatment, the patient showed improvement in the skin condition and regrowth of eyelashes and eyebrows. The safest next step recommended was a reduction in the immunosuppressive regimen.
