Document Detail


Viral-associated trichodysplasia of immunosuppression: report of a pediatric patient with response to oral valganciclovir.
MedLine Citation:
PMID:  20713819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Viral-associated trichodysplasia of immunosuppression is an increasingly recognized entity characterized by follicular-based papules, primarily in the central part of the face, that produce variable degrees of alopecia and dysmorphic features. It has been primarily described in transplant recipients but has recently been recognized in patients receiving chemotherapy for leukemia and lymphoma. It is associated with distinctive histologic features such as dilated anagen hair follicles, absent hair papillae, and abrupt cornification of the inner root sheath. OBSERVATIONS: A 5-year-old boy presented with spiny follicular papules that caused thickening of the skin of the face 1 year after cardiac transplantation. He had been exposed to several immunosuppressive agents, including mycophenolate mofetil, tacrolimus, intravenous immunoglobulin, rituximab, cylcophosphamide, and prednisone. Despite the failure of multiple topical treatments, our patient's eruption improved with systemic valganciclovir therapy. CONCLUSIONS: We describe the youngest patient (to our knowledge) with viral-associated trichodysplasia of immunosuppression and discuss the characteristic clinicopathologic features. Our report supports the theory that immunosuppression is the predisposing factor to a folliculotropic papovavirus that alters follicular maturation.
Authors:
Taylor Benoit; Rocky Bacelieri; Dean S Morrell; John Metcalf
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of dermatology     Volume:  146     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-17     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  871-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, 135 Rutledge Ave., Charleston, SC 29425, USA. benoitm@musc.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Age Factors
Antiviral Agents / administration & dosage,  therapeutic use*
Child, Preschool
Facial Dermatoses / drug therapy*,  pathology,  virology
Ganciclovir / administration & dosage,  analogs & derivatives*,  therapeutic use
Heart Transplantation / methods
Humans
Immunocompromised Host
Immunosuppressive Agents / adverse effects,  therapeutic use
Male
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Immunosuppressive Agents; 0/valganciclovir; 82410-32-0/Ganciclovir

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