Polyomavirus Associated Trichodysplasia Spinulosa in a Pediatric Kidney Transplant Recipient
Bibliographic record
Abstract
BACKGROUND: Trichodysplasia spinulosa (TS) is an inconspicuous cutaneous infection caused by a distinct polyoma virus affecting the immunocompromised host. TS is rare in children and can masquerade as other dermatological conditions, causing a delay in diagnosis. There is a lack of evidence regarding standard treatment guidelines due to the rarity of the condition. METHODS: Here, we report a case of TS in a 10-year-old girl who underwent a deceased donor kidney transplant and later developed spiculated white papules over her entire body. RESULTS: A definitive diagnosis of TS was made by skin biopsy, showing TS in the hair follicle. Paraffin scrolls of the specimen were positive for trichodysplasia spinulosa polyomavirus small T antigen viral gene. The patient was successfully treated with a reduction in immunosuppression and the addition of leflunomide and valganciclovir. She remained negative for BK virus in the serum and did not develop rejection of her graft. CONCLUSION: This case demonstrates a rare infectious complication following pediatric solid organ transplantation and highlights the extensive distribution and slow response to ultimately successful treatment of TS with timely reduction in immunosuppression. However, the role of valganciclovir remains uncertain in the management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".