To the Editor.—
With long-term use of cyclosporine, various dermatologic and mucosal side effects have been noted, including hypertrichosis, sebaceous hyperplasia, epidermal cysts, keratosis pilaris, acne, folliculitis, cutaneous malignancies, human papilloma virus infection, and gingival hyperplasia.1,2 We describe two patients treated with cyclosporine who developed multiple papillomatous facial lesions.
Report of Cases.—Case 1.—
A 36-year-old man who had received a kidney transplant 3 years earlier presented with multiple papules on the chin of 2 years' duration. Medications included cyclosporine (3.6 mg/kg per day), minoxidil, propranolol, furosemide, nifedipine, and prednisone. Physical examination revealed multiple firm, erythematous 2- to 10-mm papules over the chin (Fig 1). Histologic examination of a papule showed moderate acanthosis and mild hypergranulosis of the epidermis. Koilocytosis was absent. In the dermis there was an increased number of ectatic capillaries, mild lymphocytic inflammation, mild fibrosis, and edema (Fig 2). Follicles and sebaceous glands were slightly
Valicenti JMK, Pakula A, Caro WA, Malkinson FD. Papilloma Development in Cyclosporine-Treated Patients. Arch Dermatol. 1993;129(6):794–795. doi:10.1001/archderm.1993.01680270138031
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