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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Main Authors: Bidhan Neupane, Jayanti Jwarchan, Bishnu Prasad Adhikari, Ajay Kumar, Surendra Sapkota, Subash Paudel, Ashmita Oli
Format: Article
Language:English
Published: Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) 2025-03-01
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
description 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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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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