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Complete resolution of trichodysplasia spinulosa in a pediatric renal transplant patient: Case report and literature review. Pediatr Transplant 2017 Mar;21(2)

Date

12/27/2016

Pubmed ID

28019062

DOI

10.1111/petr.12849

Scopus ID

2-s2.0-85007170375   15 Citations

Abstract

TS of immunosuppression is a rare, disfiguring dermatologic condition caused by TS-associated polyomavirus in immunosuppressed patients. It is difficult to treat, with no clearly described approach to resolve the condition completely and safely. We report a child with a renal transplant who developed TS and was treated with significant reduction in immunosuppression and transient use of cidofovir cream. The combined approach, primarily with significant long-term reduction in immunosuppression guided by monitoring BK viremia in our patient, led to complete resolution of TS without recurrence or graft rejection by 5 years after transplant. This outcome was superior to all other reports of TS in children after transplantation. Closely monitoring for BK viremia, as a surrogate marker of over-immunosuppression, can guide adjustment in immunosuppressant medication to treat polyomavirus disease without developing the complication of graft rejection in a patient at significant risk.

Author List

Coogle LP, Holland KE, Pan C, Van Why SK

Authors

Kristen E. Holland MD Associate Professor in the Dermatology department at Medical College of Wisconsin
Cynthia G. Pan MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Scott K. Van Why MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

BK Virus
Biopsy
Child
Graft Rejection
Humans
Immunocompromised Host
Immunosuppressive Agents
Kidney Failure, Chronic
Kidney Transplantation
Male
Polyomavirus Infections
Recurrence
Renal Insufficiency
Skin
Skin Diseases
Treatment Outcome
Tumor Virus Infections