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Abstract: FR-PO778

Trichodysplasia Spinulosa: A Rare, Widespread Eruption in a Kidney Transplant Patient

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical


  • Perez, Mariana E., University of Miami School of Medicine, Miami, Florida, United States
  • Mohsin, Noreen, University of Miami School of Medicine, Miami, Florida, United States
  • Cabeza Rivera, Franco H., University of Miami School of Medicine, Miami, Florida, United States

Trichodysplasia Spinulosa (TS) is a rare dermatologic condition that occurs primarily in immunocompromised populations carrying the trichodysplasia spinulosa-associated polyomavirus (TSPyV), though its pathophysiology remains incompletely understood. Lesions are commonly described as flesh-colored or erythematous folliculocentric papules with protruding keratin spines and may be pruritic as well as cosmetically disfiguring if left untreated.

Case Description

A 37-year-old female with a history of deceased-donor kidney transplantation 7 months prior was referred to the dermatology clinic for a 1-month history of a pruritic, follicular rash on the face, arms, and back following the discontinuation of prophylactic valganciclovir. She was initially prescribed azelaic acid for suspected acneiform eruption on the face and triamcinolone for pruritic papules on the body. She returned 9 months later with progression of the rash and spread to her lower extremities. A punch biopsy of the patient’s cheek eventually confirmed the diagnosis of TS after 13 months. The patient was prescribed cidofovir cream and tretinoin and referred to the Transplant Infectious Disease clinic.


Due to its scarcity in medical literature, patients with TS are often misdiagnosed, leading to treatment delays and disease progression. With no standardized treatment guidelines for TS, patients can undergo several ineffective treatment trials. While the condition typically regresses after resolution of the immunosuppressive state, this can prove to be challenging in some transplant recipients, particularly those who are highly sensitized or had prior transplant rejection. Several other treatment options have been trialed with varying levels of success, the most efficacious reportedly being topical cidofovir and oral valganciclovir. Increased awareness of this condition along with close, multi-specialty interprofessional collaboration is required to expedite diagnosis, solidify a treatment plan, and ultimately improve the quality of life of solid-organ transplant patients.