Viral-Associated Trichodysplasia

Trichodysplasia Spinulosa: Rare Presentation of Polyomavirus Infection in Immunocompromised Patients

“…Systemic valganciclovir and valacyclovir and topical acyclovir and cidofovir have been reported to be effective in treating TS.1--14,11,27,28 Of these antiviral medications, topical cidofovir 1% or 3% cream, applied twice daily, and valganciclovir 900 mg, applied twice daily, have been most com m only used. 6,[12][13][14]19,22,26 Oral valganciclovir is reported to be the best treatment, with patients showing nearly complete resolution. 6,[12][13][14]19,22,26 Other treatments that have been used include topical steroids, topical and systemic antibacterials, topical and systemic retinoids, and topical imiquimod, all of which have either provided minimal benefit or been ineffective.1,5,6,16,20 A small proportion of patients (three of nine reported), experi enced some improvement with the use of topical retinoids (tretinoin or tazarotene).14,16,1"'22 It is unclear if these topical vitamin A derivatives alter the state of viral infection or simply diminish the cutaneous manifestations of TS.…”

Trichodysplasia Spinulosa in a 7‐Year‐Old Boy Managed Using Physical Extraction of Keratin Spicules

“…A cytosine analog inhibiting human polymerase activity, topical cidofovir (1–3%), twice daily may lead to mild-to-moderate improvement in TS eruptions 7 . However, as was this case here, it can be difficult and expensive to access.…”

“…The specific presence of TSPyV has been confirmed by PCR from biopsy samples or immunohistochemistry. Topical cidofovir (1–3%) cream and oral valganciclovir have been reported as possible treatment options 7,8 . We present a case in which the presence of TSPyV was confirmed by PCR from skin scrapings.…”

Treatment of human polyomavirus‐7‐associated rash and pruritus with topical cidofovir in a lung transplant patient: Case report and literature review

“…Intravenous cidofovir has been used off‐label to treat refractory PVAN in kidney transplant recipients (although its efficacy has not been conclusively demonstrated); although small cohorts have shown no benefit of adding intravenous cidofovir or leflunomide to already reduced dosages of immunosuppressive drugs . Better responses are reported in TS, as clinical resolution was noted with topical application of 1% and 3% cidofovir to affected areas . With genetic overlap within the polyomaviridae family, we considered topical cidofovir for the theoretical possibility that it might have some activity in our case; intravenous cidofovir was not considered because of his chronic kidney disease and concerns for progression, owing to the nephrotoxicity associated with this formulation.…”