title: Trichodysplasia spinulosa associated with chemotherapy for acute lymphocytic leukaemia.
abstract: We report two boys with trichodysplasia spinulosa associated with chemotherapy for acute lymphocytic leukaemia. Trichodysplasia spinulosa is a cutaneous viral infection of immunosuppressed patients that causes abnormal hair follicle maturation. Our patients presented with widespread papules, some extruding a central keratin spicule, which were most prominent on the face. Histopathology demonstrated hair follicles dilated by a proliferation of large eosinophilic cells containing numerous abnormal trichohyaline granules. Electron microscopy in case 1 revealed 30-nm viral particles in the stratum corneum consistent with a papovavirus. In case 1, the eruption persisted despite topical salicyclic acid 4%, ammonium lactate 17.5%, tretinoin 0.05% and oral acitretin. However, it resolved once the patient's immune function returned to normal (total duration of 2 years). In case 2, the eruption spontaneously resolved after 9 months. This case report discusses the characteristic clinicopathological features of trichodysplasia spinulosa and, for the first time, follows the condition's natural history.
authors.affiliation: Department of Dermatology, Princess Margaret Hospital, Subiaco, WA, Australia. gen_sadler@xcitelogic.com.au
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Sadler
authors.forename: Anne R
authors.initials: AR
authors.lastname: Halbert
authors.forename: Nicholas
authors.initials: N
authors.lastname: Smith
authors.forename: Maureen
authors.initials: M
authors.lastname: Rogers
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D005148:Facial Dermatoses / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006201:Hair Diseases / Q000139:chemically induced* / Q000473:pathology / Q000821:virology; D018859:Hair Follicle / Q000473:pathology / Q000821:virology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents