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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
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Atopic dermatitis associated with systemic tacrolimus: Case report and review
Sheenagh J K Luijk1, Cathryn J Sibbald1
1Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada.
SAGE Open Medical Case Reports
|September 2, 2025
Summary
Systemic tacrolimus may induce atopic dermatitis (AD) in transplant patients. Switching immunosuppression to sirolimus and a single dupilumab dose resolved AD in a pediatric liver transplant recipient.
Area of Science:
- Immunology
- Dermatology
- Transplantation
Background:
- Post-transplant immunosuppression is crucial for graft survival.
- Tacrolimus is a common immunosuppressant used after organ transplantation.
- Atopic dermatitis (AD) is a chronic inflammatory skin condition.
Observation:
- A 10-month-old female developed new-onset atopic dermatitis (AD) 110 days post-liver transplant.
- The patient was receiving systemic tacrolimus monotherapy for immunosuppression.
- Conventional AD treatments were ineffective.
Findings:
- The patient's AD was suspected to be associated with tacrolimus therapy.
- Switching immunosuppression from tacrolimus to sirolimus led to significant skin improvement.
- A single dose of dupilumab was administered, after which her eczema completely cleared.
Implications:
- Systemic tacrolimus may be an underrecognized trigger for atopic dermatitis in transplant recipients.
- Sirolimus may be a viable alternative immunosuppressant in patients developing AD.
- Further research is warranted to elucidate the link between tacrolimus and AD induction.
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