Virus-associated trichodysplasia spinulosa Journal Article


Authors: Wyatt, A. J.; Sachs, D. L.; Shia, J.; Delgado, R.; Busam, K. J.
Article Title: Virus-associated trichodysplasia spinulosa
Abstract: Virus-associated trichodysplasia spinulosa (VATS) is a cutaneous eruption of spiny papules predominantly affecting the face that is associated with a distinctive histologic picture of abnormally maturing anagen follicles with excessive inner root sheath differentiation and hyperkeratotic infundibula. Ultrastructurally, intranuclear viral particles consistent with polyoma virus are found. Only 2 patients have thus far been reported. Both had developed the eruption after a kidney transplant. We report 2 additional cases of VATS. One is an 8-year-old boy who presented with facial papules after a kidney transplant. The other is a 19-year-old man with a history of acute lymphocytic leukemia who never had a transplant. He developed a papular facial eruption as well as alopecia. Light microscopic and ultrastructural examinations revealed a spectrum in the severity of the histologic alterations as well as the number of intranuclear viral particles. This report expands the range of pathologic alterations associated with VATS and documents for the first time that it can affect patients without a solid organ transplant. The similarity of the clinical and histologic features of VATS with those previously reported by others as cyclosporine-induced "follicular dystrophy" or "pilomatrix dysplasia" raises the possibility that the described phenomena may reflect the same entity. Increased awareness of the distinct histologic picture associated with VATS will likely lead to more frequent diagnosis of this underrecognized entity.
Keywords: adult; child; human tissue; human cell; clinical feature; microscopy; case report; animals; polyoma virus; polyomavirus; papule; acute lymphocytic leukemia; alopecia; virus particle; skin infection; kidney transplantation; microscopy, electron, transmission; hair follicle; hair root; virion; hair growth; virus associated trichodysplasia spinulosa; leukemia, lymphocytic; hair diseases; keratosis pilaris; lchen spinulosus; trichodysplasia; facial dermatoses; intranuclear inclusion bodies
Journal Title: American Journal of Surgical Pathology
Volume: 29
Issue: 2
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2005-02-01
Start Page: 241
End Page: 246
Language: English
DOI: 10.1097/01.pas.0000149691.83086.dc
PUBMED: 15644782
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 20" - "Export Date: 24 October 2012" - "CODEN: AJSPD" - "Source: Scopus"
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  1. Ruby Delgado
    26 Delgado
  2. Dana L Sachs
    23 Sachs
  3. Jinru Shia
    719 Shia
  4. Klaus J Busam
    688 Busam