Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression
Acquired epidermodysplasia verruciformis (EV) is a rare dermatologic disorder linked to increased susceptibility to specific HPV infections in immunosuppressed states. We report a 43-year-old renal transplant recipient on prolonged immunosuppressive therapy with tacrolimus, mycophenolate mofeti...
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Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
2025-03-01
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| Series: | Nepal Journal of Dermatology, Venereology & Leprology |
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| Online Access: | https://www.nepjol.info/index.php/NJDVL/article/view/74640 |
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| author | Bidhan Neupane Jayanti Jwarchan Bishnu Prasad Adhikari Ajay Kumar Surendra Sapkota Subash Paudel Ashmita Oli |
| author_facet | Bidhan Neupane Jayanti Jwarchan Bishnu Prasad Adhikari Ajay Kumar Surendra Sapkota Subash Paudel Ashmita Oli |
| author_sort | Bidhan Neupane |
| collection | DOAJ |
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Acquired epidermodysplasia verruciformis (EV) is a rare dermatologic disorder linked to increased susceptibility to specific HPV infections in immunosuppressed states. We report a 43-year-old renal transplant recipient on prolonged immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and corticosteroids who developed multiple asymptomatic wart-like papules and plaques on extremities, hypopigmented pityriasis versicolor-like macules on the trunk, and seborrheic keratosis-like lesions on the face. Histopathology confirmed EV, showing acanthosis, hyperkeratosis, and keratinocytes with pale blue cytoplasm, perinuclear halos, and mild nuclear dysplastic changes. Due to malignancy risk in sun-exposed areas, strict sun protection and follow-up were advised. With acitretin and imiquimod unavailable, lesions were managed with intralesional measles, mumps, rubella (MMR) vaccine, and topical keratolytic, resulting in partial regression. This case highlights the need for early recognition, vigilant monitoring, and tailored management of EV in immunosuppressed patients, emphasizing further research to refine therapeutic strategies in resource-limited settings.
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| format | Article |
| id | doaj-art-4149508aa33a4918af6757ffce7a98ef |
| institution | Kabale University |
| issn | 2091-0231 2091-167X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) |
| record_format | Article |
| series | Nepal Journal of Dermatology, Venereology & Leprology |
| spelling | doaj-art-4149508aa33a4918af6757ffce7a98ef2025-08-23T10:03:23ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2025-03-0123110.3126/njdvl.v23i1.74640Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of ImmunosuppressionBidhan Neupane0https://orcid.org/0009-0000-8250-3960Jayanti Jwarchan1Bishnu Prasad Adhikari2https://orcid.org/0009-0005-5089-4465Ajay Kumar3Surendra Sapkota4Subash Paudel5Ashmita Oli6https://orcid.org/0009-0003-5491-0704Manipal College of Medical Sciences, Pokhara, NepalManipal College of Medical Sciences, Pokhara, NepalManipal College of Medical Sciences, Pokhara, NepalManipal College of Medical Sciences, Pokhara, NepalManipal College of Medical Sciences, Pokhara, NepalManipal College of Medical Sciences, Pokhara, NepalTribhuvan University Institute of Medicine, Maharajgunj Nursing Campus Acquired epidermodysplasia verruciformis (EV) is a rare dermatologic disorder linked to increased susceptibility to specific HPV infections in immunosuppressed states. We report a 43-year-old renal transplant recipient on prolonged immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and corticosteroids who developed multiple asymptomatic wart-like papules and plaques on extremities, hypopigmented pityriasis versicolor-like macules on the trunk, and seborrheic keratosis-like lesions on the face. Histopathology confirmed EV, showing acanthosis, hyperkeratosis, and keratinocytes with pale blue cytoplasm, perinuclear halos, and mild nuclear dysplastic changes. Due to malignancy risk in sun-exposed areas, strict sun protection and follow-up were advised. With acitretin and imiquimod unavailable, lesions were managed with intralesional measles, mumps, rubella (MMR) vaccine, and topical keratolytic, resulting in partial regression. This case highlights the need for early recognition, vigilant monitoring, and tailored management of EV in immunosuppressed patients, emphasizing further research to refine therapeutic strategies in resource-limited settings. https://www.nepjol.info/index.php/NJDVL/article/view/74640Acquired epidermodysplasia verruciformisEpidermodysplasia VerruciformisHuman PapillomavirusImmunosuppressionRenal transplant |
| spellingShingle | Bidhan Neupane Jayanti Jwarchan Bishnu Prasad Adhikari Ajay Kumar Surendra Sapkota Subash Paudel Ashmita Oli Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression Nepal Journal of Dermatology, Venereology & Leprology Acquired epidermodysplasia verruciformis Epidermodysplasia Verruciformis Human Papillomavirus Immunosuppression Renal transplant |
| title | Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression |
| title_full | Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression |
| title_fullStr | Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression |
| title_full_unstemmed | Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression |
| title_short | Acquired Epidermodysplasia Verruciformis Post-renal Transplant: A Case Report of Rare Manifestation of Immunosuppression |
| title_sort | acquired epidermodysplasia verruciformis post renal transplant a case report of rare manifestation of immunosuppression |
| topic | Acquired epidermodysplasia verruciformis Epidermodysplasia Verruciformis Human Papillomavirus Immunosuppression Renal transplant |
| url | https://www.nepjol.info/index.php/NJDVL/article/view/74640 |
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