Abstract
Sirolimus is a new immunosuppressive agent used to prevent rejection in renal allograft recipients in order to reduce the need of potentially nephrotoxic calcineurin inhibitors (cyclosporine, tacrolimus). The cutaneous side effects of sirolimus are not well known and they may have been underestimated. We report 2 cases of follicular acneiform eruptions induced by sirolimus in renal allograft recipients. This dermatologic complication was severe and difficult to treat, and resolved only after discontinuation of sirolimus.
References
1.
Vasquez EM: Sirolimus: a new agent for prevention of renal allograft rejection. Am J Health Syst Pharm 2000;57:437–448; quiz 449–451.
2.
Kreis H, Oberbauer R, Campistol JM, Mathew T, Daloze P, Schena FP, et al: Long-term benefits with sirolimus-based therapy after early cyclosporine withdrawal. J Am Soc Nephrol 2004;15:809–817.
3.
Magee CC, Pascual M: Update in renal transplantation. Arch Intern Med 2004;164:1373–1388.
4.
Bedane C, Souyri N: Induced acne (in French). Ann Dermatol Venereol 1990;117:53–58.
5.
O’Connell BM, Abel EA, Nickoloff BJ, Bell BJ, Hunt SA, Theodore J, et al: Dermatologic complications following heart transplantation. J Heart Transplant 1986;5:430–436.
6.
el-Shahawy MA, Gadallah MF, Massry SG: Acne: a potential side effect of cyclosporine A therapy. Nephron 1996;72:679–682.
7.
Pham PT, Pham PC, Danovitch GM, Ross DJ, Gritsch HA, Kendrick EA, et al: Sirolimus-associated pulmonary toxicity. Transplantation 2004;77:1215–1220.
8.
Mahé E, Morelon E, Ducasse M, Kreis H, De Prost Y, Bodemer C: Evaluation dermatologique de 71 patients transplantés rénaux sous immunosuppression comprenant du sirolimus. Ann Dermatol Venereol 2003;130:4S65.
9.
Montalbano M, Neff GW, Yamashiki N, Meyer D, Bettiol M, Slapak-Green G, et al: A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications. Transplantation 2004;78:264–268.
10.
Reitamo S, Spuls P, Sassolas B, Lahfa M, Claudy A, Griffiths CE: Efficacy of sirolimus (rapamycin) administered concomitantly with a subtherapeutic dose of cyclosporin in the treatment of severe psoriasis: a randomized controlled trial. Br J Dermatol 2001;145:438–445.
11.
Kahan BD: Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: a randomised multicentre study. The Rapamune US Study Group. Lancet 2000;356:194–202.
12.
Raymond E, Alexandre J, Faivre S, Vera K, Materman E, Boni J, et al: Safety and pharmacokinetics of escalated doses of weekly intravenous infusion of CCI-779, a novel mTOR inhibitor, in patients with cancer. J Clin Oncol 2004;22:2336–2347.
13.
Dereure O: Skin reactions related to treatment with anticytokines, membrane receptor inhibitors and monoclonal antibodies. Expert Opin Drug Saf 2003;2:467–473.
14.
Laffitte E, Saurat JH: Kinase inhibitor-induced pustules. Dermatology 2005;211:305–306.
15.
Mimeault M, Bonenfant D, Batra SK: New advances on the functions of epidermal growth factor receptor and ceramides in skin cell differentiation, disorders and cancers. Skin Pharmacol Physiol 2004;17:153–166.
16.
Nomura M, He Z, Koyama I, Ma WY, Miyamoto K, Dong Z: Involvement of the Akt/mTOR pathway on EGF-induced cell transformation. Mol Carcinog 2003;38:25–32.
17.
Marcusson JA, Tyden G: Acne conglobata in transplant patients treated with isotretinoin. Br J Dermatol 1988;118:310–312.
© 2005 S. Karger AG, Basel
2005
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