Kadam Pooja, Pan Teddy, Gates Rachelle, Rivetz Jessica, Rady Peter, Tyring Stephen, Carlson John A
Dermatology, Phlebology and Fluid Mechanics Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia.
Departments of Dermatology, Microbiology/Medical Genetics, and Internal Medicine, University of Texas Health Science Center, Houston, TX.
Am J Dermatopathol. 2017 Dec;39(12):928-931. doi: 10.1097/DAD.0000000000000941.
Viral associated trichodysplasia spinulosa (VATS) is a rare cutaneous eruption characterized by folliculocentric papules, keratin spicules, and alopecia associated with trichodysplasia spinulosa-associated polyomavirus (TSPyV) infection. We report a case of a 6-year-old male child who presented with a generalized papular eruption during chemotherapy for acute lymphoblastic leukemia. The papules were tested for human papillomavirus (HPV) DNA by nested polymerase chain reaction (PCR) and TSPyV using PCR and gene sequencing studies. The lesions were positive for TSPyV by PCR combined with sequencing and showed high copy number with real-time PCR, and beta-papillomavirus was identified by PCR and sequencing. Immunohistochemistry revealed inner root sheath keratinocytes expressing nuclear HPV L1 capsid antigen. To our knowledge, this is the first case of concomitant productive HPV and TSPyV infection in a VATS-affected patient. The presence of HPV may be coincidental, however, further studies are needed to establish whether specific HPV genotypes influence the development of abnormal inner root sheath trichohyalin granules found in VATS.
病毒相关性棘状毛囊发育不良（VATS）是一种罕见的皮肤疹，其特征为以毛囊为中心的丘疹、角质小刺以及与棘状毛囊发育不良相关多瘤病毒（TSPyV）感染相关的脱发。我们报告一例6岁男童，在急性淋巴细胞白血病化疗期间出现全身性丘疹性皮疹。通过巢式聚合酶链反应（PCR）检测丘疹中的人乳头瘤病毒（HPV）DNA，并使用PCR和基因测序研究检测TSPyV。PCR结合测序显示病变TSPyV呈阳性，实时PCR显示其拷贝数高，PCR和测序鉴定出β-乳头瘤病毒。免疫组织化学显示内根鞘角质形成细胞表达核HPV L1衣壳抗原。据我们所知，这是首例VATS患者同时发生HPV和TSPyV感染的病例。HPV的存在可能是巧合，然而，需要进一步研究以确定特定的HPV基因型是否会影响VATS中发现的内根鞘毛透明颗粒异常的发展。
