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Updated: Jul 18, 2026
Murine Full-thickness Skin Transplantation
Published on: January 2, 2017
Conversion to sirolimus: a useful strategy for recalcitrant cutaneous viral warts in liver transplant recipient
Sébastien Dharancy1, Benoît Catteau, Laurent Mortier
1Service des Maladies de l'Appareil Digestif et de la Nutrition, Lille, France. s6@chru-lille.fr
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.
Insights
Transplant recipients often develop difficult-to-treat warts from human papillomavirus (HPV). Switching immunosuppression to sirolimus improved recalcitrant HPV warts, suggesting a new treatment strategy.
Area of Science:
- Dermatology
- Transplantation Medicine
- Virology
Background:
- Dermatological complications, particularly human papillomavirus (HPV) infections causing warts, are frequent in immunosuppressed transplant recipients.
- Managing these HPV-induced warts can be challenging due to impaired immune responses in transplant patients.
- Recalcitrant warts significantly impact the quality of life for transplant recipients.
Observation:
- A young liver transplant recipient presented with widespread, treatment-resistant HPV-induced warts.
- The patient's immunosuppressive regimen was modified by converting to sirolimus, a target-of-rapamycin (TOR) inhibitor.
- The conversion to sirolimus led to a notable and rapid improvement in the patient's skin condition.
Findings:
- Sirolimus, a TOR inhibitor, possesses antiproliferative and cytostatic properties.
- The modification of immunosuppression by introducing sirolimus demonstrated efficacy against recalcitrant cutaneous HPV warts.
- This case suggests a potential therapeutic benefit of sirolimus in managing HPV-related dermatological issues post-transplantation.
Implications:
- Switching to sirolimus may offer a viable treatment option for transplant recipients with severe, recalcitrant HPV warts.
- This strategy could improve the quality of life for patients experiencing significant dermatological complications after organ transplantation.
- Further research into TOR inhibitors for managing viral skin infections in immunosuppressed populations is warranted.
