Trichodysplasia spinulosa - A newly described folliculocentric viral infection in an immunocompromised host

This is a case report of an immunocompromised individual who presented with progressive alopecia, friable follicular spinous processes, and erythemato us, indurated papules. Examination of skin biopsies using light microscopy and immunohistochemistry revealed pathologic changes of the follicular inne r root sheath epithelium with dystrophic trichohyaline granules. Electron m icroscopy of thin sections of tissue revealed intracellular viral particles with a size and appearance consistent with those in the Papovaviridae fami ly. Electron microscopy of negatively stained extract from a homogenized le sion also demonstrated icosahedral viruses with papovavirus morphology. We believe this is a previously unreported folliculocentric viral infection in an immunosuppressed human host and have termed this entity "trichodysplasi a spinulosa".