Trichodysplasia Spinulosa Associated with Chemotherapy for Acute Lymphocytic Leukemia

The document reported on two boys who developed trichodysplasia spinulosa, a cutaneous viral infection, while undergoing chemotherapy for acute lymphocytic leukemia. This condition, which affects immunosuppressed patients, led to abnormal hair follicle maturation and widespread papules, particularly on the face. Histopathological analysis showed dilated hair follicles with large eosinophilic cells and abnormal trichohyaline granules, and electron microscopy identified 30-nm viral particles consistent with a papovavirus. In the first case, the condition persisted for 2 years despite various treatments but resolved when the patient's immune function normalized. In the second case, the condition resolved spontaneously after 9 months. This report highlighted the clinical and pathological features of trichodysplasia spinulosa and documented its natural history for the first time.