sirolimus and Collagen-Diseases

Sirolimus is an immunosuppressive macrolide with antineoplasic properties that is increasingly used in posttransplantation immunosuppression. The treatment is frequently associated with cutaneous side effects such as sirolimus-associated acneiform facial dermatitis, which has been observed in up to 50% of treated patients. We report a 51-year-old female with liver transplantation who developed inflammatory papules and nodules on the face and the upper chest 3 weeks after the initiation of sirolimus therapy. Sequential biopsies revealed lymphocytic infiltration of the dermis with a peculiar pattern of sebotropism, while older lesions showed acquired reactive perforating collagenosis. The lesions were responsive to hydroxychloroquine treatment despite continued sirolimus treatment.

Topics: Acneiform Eruptions; Anti-Inflammatory Agents; Collagen; Collagen Diseases; Drug Eruptions; Female; Humans; Hydroxychloroquine; Immunosuppressive Agents; Liver Transplantation; Middle Aged; Sebaceous Glands; Sebum; Sirolimus; Skin