title: Recurrent Psoriasis After Introduction of Belatacept in 2 Kidney Transplant Recipients.
abstract: Organ transplant recipients may have skin diseases as a result of immunosuppression, but psoriasis is reported infrequently. This skin condition may be induced by immunosuppression imbalance. We present 2 cases of recurrent psoriasis in 2 kidney transplant patients with belatacept-based immunosuppressive regimens. Two years after transplant, upon suspicion of calcineurin inhibitor neurotoxicity in the first patient, tacrolimus was replaced with belatacept. The patient's neurological signs resolved but the patient presented with skin lesions compatible with psoriatic plaques, successfully treated with betamethasone dipropionate and hydrocortisone. The second patient had a history of obesity and dyslipidemia, left foot amputation, and psoriasis. He received a kidney transplant, and maintenance immunosuppression included prednisone, mycophenolate mofetil, and belatacept. At posttransplant month 15, the patient presented with cutaneous erythematosus, maculopapular, and desquamative lesions compatible with psoriasis, treated with betamethasone dipropionate. The belatacept-based immunosuppressive regimens were maintained and psoriasis resolved. Psoriasis is a potential complication in kidney recipients that may recur when belatacept is used and/or tacrolimus is withdrawn as it could have happened in the first patient. The characteristics of the second case may suggest that belatacept might not have been the inciting agent. Good results were obtained with topical treatment.
authors.affiliation: Foundation for Research and Assistance in Kidney Disease (FINAER), Buenos Aires, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Cicora
authors.affiliation: Foundation for Research and Assistance in Kidney Disease (FINAER), Buenos Aires, Argentina javierroberti@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Roberti
mesh_terms: D000069594:Abatacept / Q000009:adverse effects*; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011565:Psoriasis / Q000139:chemically induced*; D012008:Recurrence
chemical_list: D007166:Immunosuppressive Agents; D000069594:Abatacept; D009173:Mycophenolic Acid; D011241:Prednisone
keywords: belatacept; immunosuppression; kidney transplantation; psoriasis; skin conditions