Rosa-Nieves Priscilla M, Borucki Robert, Georgesen Corey, Sutton Adam, Arthur Megan, Whitley Melodi Javid
Department of Dermatology University of Nebraska Medical Center Omaha Nebraska USA.
School of Medicine Ponce Health Sciences University Ponce Puerto Rico USA.
Skin Health Dis. 2023 Aug 16;3(5):e276. doi: 10.1002/ski2.276. eCollection 2023 Oct.
Trichodysplasia spinulosa (TS) is a rare disease that affects immunocompromised patients, characterized by hair-like growths caused by infection. Little is known about specific immunosuppressive drugs that can precipitate the condition. We report a case of TS presenting after initiating the oral Janus-associated kinase inhibitor (JAKi) ruxolitinib. A 67-year-old female with a history of allogeneic bone marrow transplant requiring immunosuppression with tacrolimus, prednisone and, more recently, ruxolitinib 5 mg twice daily due to Graft versus Host Disease presented to the clinic with a facial rash. The clinical and histopathological findings in the setting of immunosuppression were consistent with TS. Initial treatments were ineffective, but oral acitretin showed significant improvement after 3 months. Due to the close temporal relationship between the initiation of ruxolitinib and the development of TS, this case suggests that JAKis may contribute to TS development by suppressing the JAK-signal transducer and activator of the transcription pathway's antiviral functions.
棘状毛发发育异常（TS）是一种影响免疫功能低下患者的罕见疾病，其特征为感染导致的毛发样增生。对于可引发该病的特定免疫抑制药物知之甚少。我们报告一例在开始口服Janus相关激酶抑制剂（JAKi）鲁索替尼后出现TS的病例。一名67岁女性，有同种异体骨髓移植病史，因移植物抗宿主病需要使用他克莫司、泼尼松进行免疫抑制，最近因该病开始每天两次服用5mg鲁索替尼，该患者因面部皮疹到诊所就诊。免疫抑制情况下的临床和组织病理学表现与TS一致。初始治疗无效，但口服阿维A在3个月后显示出显著改善。由于鲁索替尼开始使用与TS发生之间存在密切的时间关系，该病例提示JAKi可能通过抑制JAK信号转导和转录激活因子途径的抗病毒功能而促使TS发生。
