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Trichodysplasia Spinulosa Associated With Lupus

Moktefi, Anissa MD*; Laude, Hélène MD, PhD†,‡; Brudy Gulphe, Laurence MD§; Rozenberg, Flore MD, PhD†,‡; Vacher Lavenu, Marie Cécile MD, PhD*; Dupin, Nicolas MD‡,§; Carlotti, Agnès MD*

The American Journal of Dermatopathology: March 2014 - Volume 36 - Issue 3 - p e70–e74
doi: 10.1097/DAD.0b013e318293f620
Extraordinary Case Report

Abstract: Trichodysplasia spinulosa (TS) is a unique clinical and histological entity described in immunosuppressed patients. The recent discovery of genomic DNA from a new Polyomavirus named trichodysplasia spinulosa–associated Polyomavirus in TS lesions and good clinical response to cidofovir strengthens the hypothesis of a viral etiology for the disease. The authors report a case of TS associated with lupus erythematosus in a 26-year-old woman with no history of transplant, hemopathy, or cyclosporine treatment. The patient developed a progressive worsening eruption composed of confluent papules and spiky filiform excrescences concentrated in the midfacial area. Pathological features were characterized by aberrant distended and abnormally maturated hair follicles with sheets of eosinophilic cells containing large purple granules, and the presence of trichodysplasia spinulosa–associated Polyomavirus DNA was confirmed by polymerase chain reaction. This case is the first description in a nontransplanted lupus patient without underlying hemopathy.

Departments of *Pathology and

Virology, Assistance Publique des Hôpitaux de Paris, Cochin Hospital, Paris, France;

Unit EA1833, Paris Descartes University, Paris, France; and

§Department of Dermatology, Assistance Publique des Hôpitaux de Paris, Cochin Hospital, Paris, France.

Reprints: Agnès Carlotti, MD, Department of Pathology, Hôpital Cochin, Service d’Anatomie Pathologique, 124 rue du Faubourg Saint Jacques, 75014 Paris, France (e-mail:

The authors declare no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.