Steinmetz Carsten Z, Getz Amanda, Schaffer Andras, Richardson Stephen K
Edward Via College of Osteopathic Medicine, Spartanburg, SC.
Florida State University College of Medicine, Tallahassee, FL.
HCA Healthc J Med. 2023 Aug 29;4(4):315-319. doi: 10.36518/2689-0216.1524. eCollection 2023.
Eruptive sebaceous hyperplasia (ESH) is a benign process characterized by the acute onset and rapid proliferation of sebaceous glands, typically on the face. Although historically attributed to cyclosporine therapy, the preponderance of reports over the past 2 decades suggests a more complex etiology. There is increasing thought a combination of multiple medications as well as a genetic component contribute to ESH's clinical presentation. Despite these theories, the exact cause of ESH in immunosuppressive therapy is poorly understood.
To our knowledge, we report the third case of ESH arising in multimodality immunosuppressive therapy, consisting of tacrolimus, mycophenolate mofetil, and prednisone, affecting a renal transplant patient. Our patient began cyclosporine monotherapy at an early age but did not see eruption of lesions until years later after following a multimodal therapy.
We discuss the association of ESH with other medical conditions and treatments. We hope this case sheds light on a possible complication of multimodal immunosuppressive therapy in renal transplant patients. This will allow patients and providers to be better informed of the pros and cons of different treatment options for immunosuppressive therapy in renal transplant patients.
爆发性皮脂腺增生(ESH)是一种良性病变,其特征为皮脂腺急性发作并迅速增生,通常发生于面部。尽管历史上认为其与环孢素治疗有关,但过去20年的大量报道表明其病因更为复杂。越来越多的观点认为,多种药物的联合使用以及遗传因素共同导致了ESH的临床表现。尽管有这些理论,但免疫抑制治疗中ESH的确切病因仍知之甚少。
据我们所知,我们报告了第三例在接受由他克莫司、霉酚酸酯和泼尼松组成的多模式免疫抑制治疗的肾移植患者中出现的ESH病例。我们的患者早年开始使用环孢素单药治疗,但直到多年后采用多模式治疗才出现皮损。
我们讨论了ESH与其他疾病及治疗的关联。我们希望该病例能为肾移植患者多模式免疫抑制治疗的一种可能并发症提供线索。这将使患者和医疗人员能更好地了解肾移植患者免疫抑制治疗不同选择的利弊。