Sirolimus-Induced Rash in a Kidney Transplant Patient

Zachary Bruss; Shanza Farook; Sana Shah; Abu Baker Sheikh

doi:10.12890/2022_003565

Sirolimus-Induced Rash in a Kidney Transplant Patient

Eur J Case Rep Intern Med. 2022 Sep 22;9(9):003565. doi: 10.12890/2022_003565. eCollection 2022.

Authors

Zachary Bruss¹, Shanza Farook², Sana Shah³, Abu Baker Sheikh⁴

Affiliations

¹ Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
² Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
³ Aga Khan University, Karachi, Pakistan.
⁴ Department of Internal Medicine, Division of Hospital Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.

Abstract

Sirolimus is an inhibitor of the mammalian target of rapamycin, which is used in kidney transplant immunosuppression. The clinical spectrum of cutaneous adverse events associated with sirolimus use varies, with maculopapular rash being an uncommon side effect very rarely reported in the literature. We present the case of a 78-year-old male renal transplant recipient who developed a diffuse maculopapular pruritic rash after starting sirolimus. This case report demonstrates that maculopapular rash is an uncommon sirolimus-related side effect that must be identified promptly so the medication can be discontinued and rash progression prevented.

Learning points: Acneiform dermatitis, folliculitis, onychopathy, oral ulcers, rash and stomatitis are all common dermatological side effects of sirolimus.The occurrence of a diffuse pruritic maculopapular rash associated with sirolimus use is rare, but an important differential to keep in mind.Sirolimus cessation is required in case of diffuse pruritic maculopapular rash.

Keywords: Maculopapular rash; renal transplant; sirolimus.