Leflunomide for the treatment of trichodysplasia spinulosa in a liver transplant recipient.
Trichodysplasia spinulosa (TS) is a rare dermatologic complication associated with the immunosuppressive therapy used in solid organ transplantation. The distinctive clinical manifestation of this condition is spiny follicular papules on the face, ears, extremities, and trunk. Histopathologically, abnormally maturing hair follicles with hyperkeratotic material are noted. The condition is produced by the trichodysplasia spinulosa-associated polyomavirus. Treatment of this condition in the past has entailed a reduction in immunosuppression, topical agents such as cidofovir or retinoids, or oral valganciclovir. Herein, we report a case of generalized TS treated successfully with leflunomide.
Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.|Multi-organ Transplant Program, University Health Network, Toronto, ON, Canada.
Rawan
R
Kassar
Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.|Multi-organ Transplant Program, University Health Network, Toronto, ON, Canada.
Janis
J
Chang
Multi-organ Transplant Program, University Health Network, Toronto, ON, Canada.|Division of Dermatology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
An-Wen
AW
Chan
Liver Transplant Program, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Leslie B
LB
Lilly
Department of Pathology, University Health Network, Toronto, ON, Canada.
Ayman
A
Al Habeeb
Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.|Multi-organ Transplant Program, University Health Network, Toronto, ON, Canada.
Coleman
http://orcid.org/0000-0003-1413-0968
C
Rotstein
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D006201:Hair Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D018859:Hair Follicle / Q000473:pathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D007555:Isoxazoles / Q000627:therapeutic use*; D000077339:Leflunomide; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology
D000305:Adrenal Cortex Hormones; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D016572:Cyclosporine; D000077339:Leflunomide
complications; dermatologic complication; immunosuppressive regimens; infection and infectious agents; infectious; leflunomide; minimization/withdrawal; trichodysplasia spinulosa; trichodysplasia spinulosa-associated polyomavirus; viral