Trichodysplasia of Immunosuppression Treated with Oral Valganciclovir

The document describes a case where a 37-year-old female patient with Trichodysplasia of immunosuppression (TOI) experienced significant improvement in her condition after being treated with oral valganciclovir. The patient developed facial papules leading to extensive alopecia after a heart transplant and immunosuppressive therapy. The papules worsened when valganciclovir was replaced with acyclovir. However, reintroduction of valganciclovir at 900 mg twice daily, along with topical acyclovir, led to dramatic improvement over 5 months, and the patient maintained positive results over a year with a maintenance dose of valganciclovir. This case highlights the potential effectiveness of valganciclovir in treating TOI, despite the unknown etiology of the disease and absence of viral particles in electron microscopy. Further research is needed to clarify the causative agent and treatment mechanisms for TOI.