Viral-Associated Trichodysplasia of Immunosuppression

Viral-associated trichodysplasia of immunosuppression was increasingly recognized as a condition characterized by follicular-based papules, primarily on the central face, leading to alopecia and dysmorphic features, particularly in transplant recipients and patients undergoing chemotherapy for leukemia and lymphoma. A 5-year-old boy developed spiny follicular papules and facial skin thickening 1 year after a cardiac transplant, following exposure to multiple immunosuppressive agents. Despite the failure of various topical treatments, his condition improved with systemic valganciclovir therapy. This case, the youngest reported, supported the theory that immunosuppression predisposed individuals to a folliculotropic papovavirus that disrupted follicular maturation.