Dermatoscopy case of the month: Trichodysplasia spinulosa

Stonesifer, Connor; Husain, S. Ali; Niedt, George W.; Gallitano, Stephanie M.

doi:10.1016/j.jdcr.2021.09.018

Cited by 3 publications

(5 citation statements)

References 3 publications

(10 reference statements)

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“…5,8 Key findings on dermoscopy include perifollicular hyperpigmentation with spines and central white circles. 9 While the patient we present here did have an increased central facial concentration of keratin spines, she also had notable trunk and extremity involvement, which is rarely described in TS. 8 Given there is a scarcity of images depicting extra-facial TS involvement, the eruption on the patient's lower extremities illustrates that TS can have variable morphology including both spicules and papules with scale.…”

Section: Discussionmentioning

confidence: 44%

“…Other cutaneous manifestations of TS include alopecia of the eyebrows and facial disfigurement when left untreated 5,8 . Key findings on dermoscopy include perifollicular hyperpigmentation with spines and central white circles 9 . While the patient we present here did have an increased central facial concentration of keratin spines, she also had notable trunk and extremity involvement, which is rarely described in TS 8 .…”

Section: Discussionmentioning

confidence: 52%

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Keratotic papules on the face, trunk, and extremities of a young girl

O'Brian

Gao

Vandergriff

et al. 2023

Pediatric Dermatology

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A 5-year-old girl with a 1-year history of a heart transplant, on immunosuppression with tacrolimus and mycophenolate mofetil and oral valganciclovir for cytomegalovirus prophylaxis, presented with a papular eruption on her face, trunk, and extremities. The lesions were first noted 7 months after her transplant and had spread. There was no associated pain, pruritus, or systemic symptoms such as fever, fatigue, night sweats, or weight loss. On physical examination, numerous hyperpigmented to skin-colored folliculocentric papules with central white keratotic projections were noted on her face, ears, trunk, and extremities, with increased concentration around the patient's nose (Figures 1 and 2). In addition to keratotic spicules, pink to skincolored papules with scale were noted on the patient's lower extremities (Figure 2). A punch biopsy was obtained from a lesion on the lower extremities (Figure 3).

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 52%

Keratotic papules on the face, trunk, and extremities of a young girl

O'Brian

Gao

Vandergriff

et al. 2023

Pediatric Dermatology

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“…3,15 The most specific dermatoscopic clue for distinguishing TS from other hyperkeratotic disorders is the presence of bright white spicules that protrude peripherally from follicular openings. 16 Histologic examination shows infundibular dilatation containing hyperkeratotic and parakeratotic debris with an absent or fragmented hair shaft. The hair bulb shows proliferation of large eosinophilic (IRS) cells and overall loss of normal anagen follicle architecture.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trichodysplasia spinulosa in a bone marrow transplant recipient: A case report

Rodriguez-Bolanos

Rosen

Kamil

2022

SAGE Open Medical Case Reports

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Trichodysplasia spinulosa is a rare skin condition seen in immunocompromised patients, especially in solid organ recipients. A recent review of the literature mentioned that there are 60 reported cases. We report a case in a patient with an allogenic bone marrow transplant. The patient developed white spiky protrusions on different areas of the face which improved after decreasing immunosuppression.

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“…Alopecia most commonly involves the eyebrows but can also involve the eyelashes and scalp [1,5,19]. On dermatoscopy, TS can be distinguished from other hyperkeratotic disorders by the presence of long, bright white spicules that protrude peripherally from follicular openings, compared to the dark, confined keratin plugs seen in other hyperkeratotic conditions [20]. The differential diagnosis of TS includes folliculitis, keratosis pilaris, ulerythema, lichen spinulosus, lichen planopilaris, multiple minute digitate hyperkeratosis, spiculate demodicosis, alopecia mucinosa, trichostasis spinulosa, follicular graft-versus-host disease, and follicular spicules of multiple myeloma [5,9].…”

Section: Case Discussionmentioning

confidence: 99%