Acquired epidermodysplasia verruciformis in renal‐transplant recipients

Abstract

Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis, associated with a high susceptibility to infection with particular genotypes of human papillomaviruses (HPV) that are innocuous for the general population. Acquired forms of EV have been recently distinguished as an entity occurring in immunocompromised patients such as HIV-infected subjects or organ-transplant recipients. 1 Clinical presentation can be variable, often similar to the inherited forms. Studies reporting acquired EV in renal-transplant recipients are scarce. Herein, we report a case of an acquired EV in a renal-transplant recipient and review the available literature data. 2 | CASE REPORT A 30-year-old male patient with a four-year history of kidney transplantation for indeterminate nephropathy with end-stage renal disease and who was treated at our department for a drug reaction to amphotericin B he had received for a visceral leishmaniasis presented for a recurrence of the cutaneous eruption, evolving for the last 6 days. He was under post-transplant maintenance immunosuppressive therapy including prednisone, mycophenolate mofetil, and tacrolimus. Physical examination revealed multiple erythematous and confluent macules and papules of the torso and abdomen (Figure 1A-C). No verrucous lesions or tinea versicolor-like lesions were found. A skin biopsy of the macules was performed. Histological examination showed, in the upper epidermis, foci of keratinocytes of increased size, with enlarged nuclei and a bubbly, bluish, abundant cytoplasm, containing variably sized keratohyaline granules (Figure 2). There were no signs of drug reaction. Histological features were consistent with the diagnosis of acquired EV. There was no history of affected relatives. A regular sunscreen application and close follow-up were proposed. 3 | DISCUSSION Epidermodysplasia verruciformis is a rare inherited genodermatosis characterized by an increased susceptibility to

Acquired epidermodysplasia verruciformis (AEV) in three children after cardiac transplantation: A case series and review of the literature

“…Of the existing literature, most cases were in patients with HIV, as well as one case following renal transplantation and one following small bowel transplantation. 5,8 It is possible that this condition is more common in the transplant population, but is under-investigated given that providers may assume these lesions represent flat warts or other clinical mimickers of AEV as outlined in Table 2. It was interesting to note that all our patients were postcardiac transplant specifically and that tacrolimus was a common systemic immunosuppressant within our series as well as in prior reported cases.…”

Acquired epidermodysplasia verruciformis in a renal transplant patient: a case report

“…Acquired epidermodysplasia verruciformis (AEV) is a rare dermatosis that has recently been recognized in patients with impaired cell-mediated immunity (1). AEV has been reported in patients with human immunodeficiency virus (HIV), non-Hodgkin lymphoma, systemic lupus erythematosus, graft versus host disease (GVHD), and atopic dermatitis treated with cyclosporine, and following solid organ transplantation (2). It is caused by human papillomavirus (HPV) infection.…”