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Pediatr Transplant. 2017 Mar;21(2). doi: 10.1111/petr.12849. Epub 2016 Dec 25.

Complete resolution of trichodysplasia spinulosa in a pediatric renal transplant patient: Case report and literature review.

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Division of Nephrology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Division of Pediatric Dermatology, Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA.


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.


child; immunosuppression; kidney; literature review; polyomavirus; transplantation

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