By Gary M. White, MD
Trichodysplasia spinulosa (TS) is a viral infection produces multiple tiny follicular spicules in immunosuppressed patients. Patients typically have solid organ transplantation, acute or chronic leukemia, non-Hodgkin’s lymphoma, or multiple myeloma.
Innumerable, tiny follicular spines develop in the face and then proceed to the trunk and extremities. Alopecia of the eyebrows and eyelashes is typical. One patient with Gorlin syndrome had TS precipitated by treatment with vismodegib (Erivedge). Stopping the vismodegib led to resolution and rechallenge resulted in recurrence [JAMA Derm 2014;150;1016].
Restoring normal immune function can lead to complete remission. Both valaciclovir and valganciclovir have cleared the eruption in isolated reports.
Pediatric Dermatology 1015;32;545
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