sirolimus and Skin-Ulcer

The use of sirolimus as an alternative to calcineurin antagonists has enabled the continuation of immunosuppression in patients with renal impairment with preservation of kidney function. Sirolimus is generally well tolerated, with the main causes of cessation of therapy related to its effect on blood lipid profile as well as leukopenia and thrombocytopenia. We report a case of a debilitating ulcerating maculopapular rash necessitating cessation of the drug in a liver transplantation patient. A 56-year-old Caucasian liver transplantation patient presented with a diffuse, debilitating rash attributed to sirolimus use. This ultimately necessitated cessation of the immunosuppressant with subsequent resolution of her symptoms. From a review of the current literature, this is a highly unusual adverse reaction to sirolimus.

Topics: Drug Administration Schedule; Drug Eruptions; Female; Humans; Immunosuppressive Agents; Liver Transplantation; Middle Aged; Pruritus; Sirolimus; Skin Ulcer

Graft-versus-host-disease (GvHD) is despite improvement in transplantation medicine the major cause for morbidity and mortality after allogeneic stem cell transplantation. We describe a patient with chronic cutaneous GvHD who developed massive skin ulcerations after changing the immunosuppressive therapy to a mammalian target of rapamycin (mTOR)-inhibitor.

Topics: Everolimus; Graft vs Host Disease; Humans; Immunosuppressive Agents; Male; Middle Aged; Sirolimus; Skin Ulcer; Stem Cell Transplantation; Treatment Outcome

Topics: Aged; Antineoplastic Agents; Carcinoma, Squamous Cell; Drug Therapy, Combination; ErbB Receptors; Gefitinib; Humans; Lymphatic Metastasis; Male; Quinazolines; Sirolimus; Skin Neoplasms; Skin Ulcer; TOR Serine-Threonine Kinases