title: Conversion to sirolimus: a useful strategy for recalcitrant cutaneous viral warts in liver transplant recipient.
abstract: Dermatological complications following transplantation are very common and the majority of immunosuppressed transplant recipients develop some to many warts due to human papillomavirus (HPV) infection. In the setting of immunosuppression, therapeutic management may be disappointing because of the extent of the lesions in patients unable to develop a sufficient immune response directed against HPV. We report here a case of a young liver transplant recipient who developed diffuse recalcitrant HPV-induced warts leading to an impairment of her quality of life. Taking into account the antiproliferative and cytostatic properties of the target-of-rapamycin (TOR) inhibitors, a new class of immunosuppressive drug, we significantly modified the immunosuppressive regimen. Conversion to sirolimus was followed by a rapid improvement of cutaneous state suggesting that this strategy may be useful for recalcitrant cutaneous viral warts in transplant recipient.
authors.affiliation: Service des Maladies de l'Appareil Digestif et de la Nutrition, Lille, France. s6@chru-lille.fr
authors.forename: Sébastien
authors.initials: S
authors.lastname: Dharancy
authors.forename: Benoît
authors.initials: B
authors.lastname: Catteau
authors.forename: Laurent
authors.initials: L
authors.lastname: Mortier
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Nicole
authors.initials: N
authors.lastname: Declerck
authors.forename: Valérie
authors.initials: V
authors.lastname: Canva
authors.forename: Frédéric
authors.initials: F
authors.lastname: Piette
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
authors.forename: François René
authors.initials: FR
authors.lastname: Pruvot
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016031:Liver Transplantation; D030361:Papillomavirus Infections / Q000473:pathology / Q000517:prevention & control*; D020123:Sirolimus / Q000008:administration & dosage*; D017193:Skin Diseases, Viral / Q000473:pathology / Q000517:prevention & control*; D014860:Warts / Q000473:pathology / Q000517:prevention & control*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus