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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.

Author information

1
Division of Nephrology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
2
Division of Pediatric Dermatology, Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA.

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.

KEYWORDS:

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

PMID:
28019062
DOI:
10.1111/petr.12849
[Indexed for MEDLINE]

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