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Khalili AA, Maciagowski E, Nguyen K, Watters KA. Trichodysplasia Spinulosa. Sultan Qaboos Univ Med J 2024; 24:131-134. [PMID: 38434466 PMCID: PMC10906767 DOI: 10.18295/squmj.5.2023.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 03/05/2024] Open
Abstract
Trichodysplasia spinulosa (TS) is a unique, rare clinical and histological dermatologic entity described mainly in a setting of immunosuppression. It is caused by a novel human polymoavirus, TS-associated polyomavirus. Reduction of immunosuppression and/or anti-viral therapy is the main therapeutic strategies used to treat such cases. We report a biopsy-proven case of TS in a male renal transplant patient who presented to a dermatology outpatient clinic in Montreal, Canada, in 2015. He was managed with valgancyclovir with no obvious response. Subsequently, a trial of topical imiquimod was commenced. Awareness of TS can prompt early diagnosis and management to prevent possible complications.
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Affiliation(s)
- Ayida Al Khalili
- Dermatology Unit, Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Elsa Maciagowski
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Khue Nguyen
- Department of Dermatology, McGill University Health Center, Montreal, Canada
| | - Kevin A. Watters
- Department of Pathology, McGill University Health Center, Montreal, Canada
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Bartley BR, Moore SA, Doan HQ, Rady PL, Tyring SK. Current treatments and emerging therapies of human polyomavirus-associated skin diseases: a comprehensive review. Int J Dermatol 2023; 62:387-396. [PMID: 36577746 DOI: 10.1111/ijd.16534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
Since Merkel cell polyomavirus (MCPyV) was linked as the predominant etiology of Merkel cell carcinoma (MCC) in 2008, three additional human polyomaviruses (HPyV) have been definitively linked to cutaneous diseases-trichodysplasia spinulosa virus (TSPyV) and human polyomavirus 6 and 7 (HPyV6, HPyV7). TSPyV contributes to the development of trichodysplasia spinulosa (TS), and HPyV6/7 is associated closely with the eruption of pruritic and dyskeratotic dermatoses (PDD). Clinically, MCC is treated with surgical excision and radiation with adjuvant chemotherapy, although newer treatment options include immune checkpoint inhibition. These novel immunotherapies hold promise for the treatment of metastatic MCC, but resistance and side effects prevent a significant proportion of patients from realizing their benefits. Based on previous case reports, the standard of care for the less deadly but disfiguring cutaneous disease TS include immunosuppressant (IS) reduction, the use of antivirals such as cidofovir (CDV) or valganciclovir (VGCV), or a combination of these treatments. Similar treatments were attempted for PDD, but oral acitretin was found to be most effective. As MCC, TS, and PDD are rare diseases, further research is required for effective treatments. In this review, we summarize clinical trials, preclinical studies, and case reports that present outcomes and side effects of current and emerging treatments for HPyV-associated cutaneous diseases, offering a comprehensive resource for clinical application and prospective clinical trials.
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Affiliation(s)
- Brooke R Bartley
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Stephen A Moore
- Department of Dermatology, The University of Texas McGovern Medical School, Houston, TX, USA
| | - Hung Q Doan
- Department of Dermatology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Silling S, Kreuter A, Wieland U. [Human polyomavirus-associated skin diseases]. Hautarzt 2022; 73:426-433. [PMID: 35482045 DOI: 10.1007/s00105-022-04993-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
Of the 15 currently known human polyomaviruses (HPyV), eight have been found on healthy skin. Merkel cell polyomavirus (MCPyV), HPyV6, HPyV7, and to a lesser extent Saint Louis polyomavirus (STLPyV) are considered part of the human cutaneous virome. The most important cutaneous polyomavirus, MCPyV, causes the majority of Merkel cell carcinomas (MCC). MCC is a rare but very aggressive malignant skin tumor that affects both immunocompetent and immunosuppressed patients. A steady increase in incidence rates of this skin tumor has been observed in recent decades. MCC occurs primarily on sunlight-exposed skin of fair-skinned individuals. Risk factors for MCC development include immunosuppression and advanced age. In immunocompromised individuals, primary infection with trichodysplasia spinulosa-associated polyomavirus (TSPyV) can cause the very rare skin disease trichodysplasia spinulosa (TS). Keratin spines (spicules), mainly in the center of the face, clinically characterize this disease. Skin lesions associated with further HPyV have been described exclusively in immunocompromised individuals. For HPyV6 and HPyV7, cases of epithelial proliferation and pruritic dyskeratotic dermatitis have been published. HPyV9 and New Jersey polyomavirus (NJPyV-13) were each found in different skin lesions of individual patients. The role of these polyomaviruses in the development of the skin lesions is still unclear.
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Affiliation(s)
- Steffi Silling
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln und Universität zu Köln, Fürst-Pückler-Str. 56, 50935, Köln, Deutschland
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Oberhausen, Deutschland.,Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Johannes Klinik Duisburg, Duisburg, Deutschland
| | - Ulrike Wieland
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln und Universität zu Köln, Fürst-Pückler-Str. 56, 50935, Köln, Deutschland.
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Zanella MC, Pastor D, Feltkamp MCW, Hadaya K, Cordey S, Toutous Trellu L. Sustained Trichodysplasia Spinulosa Polyomavirus Viremia Illustrating a Primary Disseminated Infection in a Kidney Transplant Recipient. Microorganisms 2021; 9:microorganisms9112298. [PMID: 34835424 PMCID: PMC8624465 DOI: 10.3390/microorganisms9112298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 01/08/2023] Open
Abstract
Novel human polyomaviruses (HPyV) have been recently identified in solid organ transplant recipients. Trichodysplasia spinulosa (TS) is a rare disease associated with immunosuppression and induced by a polyomavirus (TSPyV). We report here a case of primary and disseminated TSPyV infection after kidney transplantation with extensive skin lesions, sustained viremia, and high viral loads in urine specimens, anal, nasal and throat swabs, assessed via specific real-time PCR for TSPyV during a follow-up period of 32 months after transplantation. The detection of TSPyV with a high viral load in respiratory and anal swab samples is compatible with viral replication and thus may suggest potential respiratory and oro-fecal routes of transmission.
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Affiliation(s)
- Marie-Céline Zanella
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
- Correspondence:
| | - Damien Pastor
- Department of Dermatology, Geneva University Hospitals, 1205 Geneva, Switzerland; (D.P.); (L.T.T.)
| | - Mariet C. W. Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Karine Hadaya
- Department of Nephrology and Hypertension, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Samuel Cordey
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
- Laboratory of Virology, Division of Infectious Diseases and Division of Laboratory Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
| | - Laurence Toutous Trellu
- Department of Dermatology, Geneva University Hospitals, 1205 Geneva, Switzerland; (D.P.); (L.T.T.)
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