Sadler Genevieve M, Halbert Anne R, Smith Nicholas, Rogers Maureen
Department of Dermatology, Princess Margaret Hospital, Subiaco, WA, Australia.
Australas J Dermatol. 2007 May;48(2):110-4. doi: 10.1111/j.1440-0960.2007.00348.x.
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.
我们报告了两名患有棘状毛囊发育异常并接受急性淋巴细胞白血病化疗的男孩。棘状毛囊发育异常是免疫抑制患者的一种皮肤病毒感染，可导致毛囊成熟异常。我们的患者出现广泛的丘疹，部分丘疹中央有角质小刺突出，面部最为明显。组织病理学显示毛囊被大量含有许多异常透明角质颗粒的嗜酸性细胞增殖所扩张。病例1的电子显微镜检查显示角质层中有30纳米的病毒颗粒，符合乳头多瘤空泡病毒。在病例1中，尽管使用了4%的水杨酸、17.5%的乳酸铵、0.05%的维甲酸局部治疗以及口服阿维A，皮疹仍持续存在。然而，一旦患者的免疫功能恢复正常（总病程2年），皮疹就消退了。在病例2中，皮疹在9个月后自行消退。本病例报告讨论了棘状毛囊发育异常的特征性临床病理特征，并首次跟踪了该疾病的自然病程。
