title: A Case Report of the Resolution of Multiple Recalcitrant Verrucae in a Renal Transplant Recipient After a Mycophenolate Mofetil Dose Reduction.
abstract: Renal transplant recipients are at an increased risk of developing verrucae due to chronic immunosuppression, and certain therapies may confer a greater risk. Herein, we describe a 51-year-old woman with a 10-year-old unrelated kidney transplant who developed numerous therapy-resistant verrucae while on mycophenolate mofetil and tacrolimus maintenance immunosuppression. Over several years of immunosuppressant therapy, she declined the approach of reducing her mycophenolate mofetil dose to potentially improve her verrucae. Unfortunately, she later developed graft rejection requiring reversion to peritoneal dialysis. Within months of reducing her mycophenolate mofetil dose (her tacrolimus dose remained unchanged), she experienced dramatic resolution of many of her verrucae. In the current case, the observed clinical improvement may have resulted from either the total reduction of immunosuppression or the specific reduction of mycophenolate mofetil. Consequently, mycophenolate mofetil may contribute to the refractory nature of verrucae within renal transplant recipients, and further research should determine the relationship between verrucae development and both specific immunosuppressant therapies and the degree of immunosuppression.
authors.affiliation: Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Mark M.
authors.initials: MM
authors.lastname: Ash
authors.affiliation: Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA. Electronic address: pjolly33@gmail.com.
authors.forename: Puneet S.
authors.initials: PS
authors.lastname: Jolly
mesh_terms: D005260:Female; D006084:Graft Rejection / Q000139:chemically induced; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects; D014860:Warts / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus