sirolimus and Facial-Dermatoses

We report a pediatric case of extensive, progressive benign cephalic histiocytosis (BCH) involving the face, trunk, and extremities with response of facial lesions to treatment with topical 1% rapamycin. A split-face model was used to demonstrate improvement on the treated side versus the untreated side. After physician and parental perception of effectiveness, based in part on photodocumentation, subsequently both cheeks were treated with continued improvement.

Topics: Administration, Cutaneous; Child, Preschool; Facial Dermatoses; Histiocytosis; Humans; Immunosuppressive Agents; Male; Ointments; Sirolimus

Topics: Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Benzenesulfonates; Bevacizumab; Cetuximab; Colonic Neoplasms; Diagnosis, Differential; Dose-Response Relationship, Drug; Drug Delivery Systems; Drug Eruptions; ErbB Receptors; Erlotinib Hydrochloride; Everolimus; Facial Dermatoses; Humans; Indoles; Liver Neoplasms; Male; Middle Aged; Neoplasms; Niacinamide; Phenylurea Compounds; Pyridines; Pyrroles; Quinazolines; Sirolimus; Sorafenib; Sunitinib; Trastuzumab

Most drug-associated angioedemas are induced by angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, or nonsteroidal anti-inflammatory drugs. Recently, the responsibility of immunosuppressive agents given to transplant recipients in the development of angioedema has been discussed.. To describe, in detail, angioedema episodes in renal transplant recipients (RTRs) on sirolimus.. A cross-sectional study in a university hospital. Eighty consecutive RTRs on sirolimus were studied.. Angioedema without urticaria occurred a mean of 5 times in 12/80 (15%) RTRs taking sirolimus. It was predominantly located on the face (83%), with mucous membrane involvement in 7 (58%) patients, and was life threatening in 1. Another putative cofactor for angioedema without urticaria was identified in 9 (75%) patients: drugs (n=8), food allergy or physical activity (n=3). Tacrolimus intake was significantly associated with sirolimus-associated angioedema.. Our results suggested a causal relationship between sirolimus and angioedema in RTRs.

Topics: Angioedema; Child, Preschool; Cross-Sectional Studies; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Postoperative Complications; Sirolimus

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.

Topics: Acneiform Eruptions; Adult; Drug Eruptions; Facial Dermatoses; Female; Graft Survival; Humans; Immunosuppressive Agents; Kidney Transplantation; Sirolimus; Transplantation, Homologous