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Rodriguez-Bolanos F, Rosen CF, Saeed Kamil ZK. Trichodysplasia spinulosa in a bone marrow transplant recipient: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221093452. [PMID: 35573099 PMCID: PMC9102115 DOI: 10.1177/2050313x221093452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Trichodysplasia spinulosa is a rare skin condition seen in immunocompromised patients, especially in solid organ recipients. A recent review of the literature mentioned that there are 60 reported cases. We report a case in a patient with an allogenic bone marrow transplant. The patient developed white spiky protrusions on different areas of the face which improved after decreasing immunosuppression.
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Affiliation(s)
| | - Cheryl F Rosen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Zaid K Saeed Kamil
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, ON, Canada
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2
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Curman P, Näsman A, Brauner H. Trichodysplasia spinulosa: a comprehensive review of the disease and its treatment. J Eur Acad Dermatol Venereol 2021; 35:1067-1076. [PMID: 33559344 PMCID: PMC8247895 DOI: 10.1111/jdv.17081] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/16/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Trichodysplasia spinulosa (TS) is a rare dermatological disease caused by TS‐associated polyomavirus (TSPyV) in immunosuppressed patients. The seroprevalence of TSPyV in immunocompetent adults is high and the number of immunosuppressed patients developing TS remains low, suggesting that TS is underdiagnosed and/or that additional unknown factors are needed in order to develop TS. There is no well‐established treatment for TS, and to date a majority of reported cases have consequently received ineffective therapies, likely due to the unavailability of reviews and recommendations of treatments for TS. The few treatments reported in case reports to be effective include topical cidofovir 3%, reduction of immunosuppression and oral valganciclovir. In this comprehensive review, we present all published cases to date, together with a summary of all treatments for TS categorized by overall clinical efficacy, thus addressing this rare disease and what appears to be its clinically efficacious treatment.
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Affiliation(s)
- P Curman
- Dermatology and Venereology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - A Näsman
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology (OnkPat), Karolinska Institutet, Stockholm, Sweden
| | - H Brauner
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden.,Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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3
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Pennou C, Javidi E, Lecours J, Bélisle A, Davar S. Trichodysplasia spinulosa in a renal transplant patient: A case report of successful treatment. SAGE Open Med Case Rep 2020; 8:2050313X20953039. [PMID: 32995002 PMCID: PMC7502798 DOI: 10.1177/2050313x20953039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Trichodysplasia spinulosa is a rare cutaneous disease caused by the trichodysplasia spinulosa–associated polyomavirus. It occurs more frequently in immunocompromised patients, particularly in solid organ transplants. A few successful treatments have been described in the literature. In our report, we present a biopsy-proven trichodysplasia spinulosa case in a kidney transplant recipient who rapidly responded to a reduction of his immunosuppressive therapy.
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Affiliation(s)
- Camille Pennou
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Eileen Javidi
- Faculty of Medecine, Université de Montréal, Montréal, QC, Canada
| | - Julie Lecours
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Annie Bélisle
- Department of Pathology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Sandra Davar
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
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Narayanan D, Rady PL, Tyring SK. Recent developments in trichodysplasia spinulosa disease. Transpl Infect Dis 2020; 22:e13434. [PMID: 32748541 DOI: 10.1111/tid.13434] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
Abstract
Trichodysplasia Spinulosa (TS) is a rare proliferative skin disease that occurs primarily in immunocompromised patients, specifically organ transplant recipients. TS is characterized by uncontrolled inner root sheath cell proliferation and folliculocentric papular eruption that can progress to disfiguring leonine facies when left untreated. TS presents with distinct histological features including the presence of large eosinophilic, trichohyaline granules within hyperproliferating inner root sheath cells of the hair bulb. The discovery of the Trichodysplasia Spinulosa Polyomavirus (TSPyV) and recent studies highlighting the role of TSPyV tumor antigens in cell proliferation pathways have provided new insight into the mechanisms of TS development. In this review, we discuss the expansion of our understanding of TS, specifically over the past 5 years. We summarize novel cases of TS and recent developments in the mechanisms underlying TSPyV-mediated disease progression. We also evaluate advancements in diagnostic methods and treatment options. As the incidence of TS continues to rise, it is becoming critical for clinicians to understand the clinical features of TS and emerging research regarding pathogenesis and therapeutics for early treatment of this potentially disfiguring disease.
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Affiliation(s)
- Deepika Narayanan
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Stephen K Tyring
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
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5
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Ciotti M, Prezioso C, Pietropaolo V. An overview on human polyomaviruses biology and related diseases. Future Virol 2019. [DOI: 10.2217/fvl-2019-0050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In recent years, the Polyomaviridae family grew rapidly, thanks to the introduction of high-throughput molecular techniques. To date, 14 polyomaviruses have been identified in humans but the association with human diseases has been established only for few of them. BKPyV has been associated with nephropathy in kidney transplant patients and hemorrhagic cystitis in hematopoietic stem cell transplant patients; JCPyV to progressive multifocal leukoencephalopathy, mainly in HIV-positive patients; Merkel cell polyomavirus to Merkel cell carcinoma; Trichodysplasia spinulosa polyomavirus to the rare skin disease Trichodysplasia spinulosa; human polyomaviruses 6 and 7 to pruritic rash. Immunocompromised patients are at risk of developing disease. Here, we summarized and discussed the scientific literature concerning the human polyomaviruses biology, seroprevalence and association with human diseases.
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Affiliation(s)
- Marco Ciotti
- Laboratory of Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Carla Prezioso
- Department of Public Health & Infectious Diseases, ‘Sapienza’ University, 00185 Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health & Infectious Diseases, ‘Sapienza’ University, 00185 Rome, Italy
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6
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Frigerio A, Toptan T, Chang Y, Abbott J, Cipriano SD, Bowen AR. Widespread keratosis pilaris-like eruption in an immunocompromised child. JAAD Case Rep 2019; 5:352-354. [PMID: 31008165 PMCID: PMC6453831 DOI: 10.1016/j.jdcr.2019.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Alice Frigerio
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Tuna Toptan
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Yuan Chang
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - James Abbott
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Sarah D Cipriano
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anneli R Bowen
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah
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7
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Sheu JC, Tran J, Rady PL, Dao H, Tyring SK, Nguyen HP. Polyomaviruses of the skin: integrating molecular and clinical advances in an emerging class of viruses. Br J Dermatol 2019; 180:1302-1311. [PMID: 30585627 DOI: 10.1111/bjd.17592] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Human polyomaviruses (HPyVs) are small, nonenveloped, double-stranded DNA viruses that express tumour antigen proteins. Fourteen species of polyomaviruses have been discovered in humans, and since the 2008 discovery of the first cutaneous polyomavirus - Merkel cell polyomavirus (MCPyV) - six more species have been detected in the skin: trichodysplasia spinulosa-associated polyomavirus (TSPyV), HPyV6, HPyV7, HPyV9, HPyV10 and HPyV13. Of these cutaneous species, only MCPyV, TSPyV, HPyV6 and HPyV7 have been definitively associated with diseases of the skin, most commonly in immunocompromised individuals. MCPyV is a predominant aetiology in Merkel cell carcinomas. TSPyV is one of the aetiological factors of trichodysplasia spinulosa. HPyV6 and HPyV7 have been recently linked to pruritic skin eruptions. The roles of HPyV9, HPyV10 and HPyV13 in pathogenesis, if any, are still unknown, but their molecular features have provided some insight into their functional biology. RESULTS In this review, we summarize the known molecular mechanisms, clinical presentation and targeted therapies of each of the eight cutaneous HPyVs. CONCLUSIONS We hope that heightened awareness and clinical recognition of HPyVs will lead to increased reports of HPyV-associated diseases and, consequently, a more robust understanding of how to diagnose and treat these conditions.
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Affiliation(s)
- J C Sheu
- Department of Dermatology, Baylor College of Medicine, Houston, TX, U.S.A
| | - J Tran
- Department of Dermatology, Baylor College of Medicine, Houston, TX, U.S.A
| | - P L Rady
- Department of Dermatology, McGovern Medical School, Houston, TX, U.S.A
| | - H Dao
- Department of Dermatology, Baylor College of Medicine, Houston, TX, U.S.A
| | - S K Tyring
- Department of Dermatology, McGovern Medical School, Houston, TX, U.S.A
| | - H P Nguyen
- Department of Dermatology, Baylor College of Medicine, Houston, TX, U.S.A.,Department of Dermatology, McGovern Medical School, Houston, TX, U.S.A.,Department of Dermatology, Emory University School of Medicine, Atlanta, GA, U.S.A
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8
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van Rijn AL, Wunderink HF, de Brouwer CS, van der Meijden E, Rotmans JI, Feltkamp MCW. Impact of HPyV9 and TSPyV coinfection on the development of BK polyomavirus viremia and associated nephropathy after kidney transplantation. J Med Virol 2019; 91:1142-1147. [PMID: 30624811 PMCID: PMC6590353 DOI: 10.1002/jmv.25397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/16/2018] [Accepted: 12/09/2018] [Indexed: 11/12/2022]
Abstract
Background BK polyomavirus (BKPyV) persistently infects the urinary tract and causes viremia and nephropathy in kidney transplantation (KTx), recipients. In a previous study, we observed an increased incidence and load of BKPyV viremia in KTx patients coinfected with human polyomavirus 9 (HPyV9). Here we sought confirmation of this observation and explored whether novel HPyVs that have been detected in urine (HPyV9 and trichodysplasia spinulosa polyomavirus [TSPyV]) potentially aggravate BKPyV infection. Methods A well‐characterized cohort of 209 KTx donor‐recipient pairs was serologically and molecularly analyzed for HPyV9 and TSPyV coinfection. These data were correlated with the occurrence of BKPyV viremia and BKPyVAN in the recipients within a year after KTx. Results Seropositivity for HPyV9 (19%) and TSPyV (89%) was comparable between donors and recipients and did not correlate with BKPyV viremia and BKPyVAN that developed in 25% and 3% of the recipients, respectively. Two recipients developed TSPyV viremia and none HPyV9 viremia. Modification of the predictive effect of donor BKPyV seroreactivity on recipient BKPyV viremia by HPyV9 and TSPyV was not observed. Conclusions Our data provide no evidence for a promoting effect of HPyV9 and TSPyV on BKPyV infection and BKPyVAN in renal allograft patients. Therefore, we do not recommend including HPyV9 and TSPyV screening in KTx patients.
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Affiliation(s)
- Aline L van Rijn
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Herman F Wunderink
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Caroline S de Brouwer
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Els van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariet C W Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
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Nguyen KD, Chamseddin BH, Cockerell CJ, Wang RC. The Biology and Clinical Features of Cutaneous Polyomaviruses. J Invest Dermatol 2018; 139:285-292. [PMID: 30470393 DOI: 10.1016/j.jid.2018.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022]
Abstract
Human polyomaviruses are double-stand DNA viruses with a conserved genomic structure, yet they present with diverse tissue tropisms and disease presentations. Merkel cell polyomavirus, trichodysplasia spinulosa polyomavirus, human polyomavirus 6 and 7, and Malawi polyomavirus are shed from the skin, and Merkel cell polyomavirus, trichodysplasia spinulosa polyomavirus, human polyomavirus 6 and 7 have been linked to specific skin diseases. We present an update on the genomic and clinical features of these cutaneous polyomaviruses.
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Affiliation(s)
- Khang D Nguyen
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Bahir H Chamseddin
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Clay J Cockerell
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Richard C Wang
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA.
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Petit A. [What's new in clinical dermatology?]. Ann Dermatol Venereol 2017; 144 Suppl 4:IVS1-IVS9. [PMID: 29249246 DOI: 10.1016/s0151-9638(17)31059-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In addition to continuous medical education, medical journals offer to dermatologists a huge variety of news that differ by their content, validity, originality and clinical relevance. I collected here various articles relative to clinical dermatology that have been published between September, 2016 and September, 2017. These papers have been chosen in the aim of reflecting such diversity. I just excluded, as far as possible, articles dealing with other issues that the reader will find further in this booklet (such as research, pediatric, instrumental, oncologic or therapeutic dermatology, or dermatology and internal medicine). Space restriction required to skip some commentaries while keeping the references to the selected papers, which the reader will be able to read carefully in its original form.
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Affiliation(s)
- A Petit
- Service de dermatologie, AP-HP hôpital Saint-Louis, Paris, France.
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11
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Biology, evolution, and medical importance of polyomaviruses: An update. INFECTION GENETICS AND EVOLUTION 2017. [DOI: 10.1016/j.meegid.2017.06.011] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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