Cyclosporine-induced sebaceous hyperplasia in a hematopoetic stem cell transplant patient: delayed onset of a common adverse event.

Cyclosporine-induced sebaceous hyperplasia (SH) is a well-documented entity, occurring in up to 30% of renal transplant patients treated with cyclosporine and has also been reported to occur following heart or hematopoetic stem cell transplantation (HCST). Cyclosporine has a stimulatory effect on undifferentiated sebocytes, resulting in the clinical and histologic findings in these patients. Sebaceous hyperplasia most commonly presents as asymptomatic papules over the face, chest, or groin. Herein we describe a case of a 27-year-old man who developed facial sebaceous hyperplasia five months after completing cyclosporine therapy for cutaneous graft versus host disease (GVHD) following HSCT.

Coexistence of basal cell carcinomas and multiple sebaceous gland hyperplasias in a cyclosporine (ciclosporin)-treated renal transplant recipient.

A 55-year-old man presented with multiple, asymptomatic, yellowish papules on his face with a 4-year history, and two non-healing tumoral lesions on his nose with a 7-month history. He was a renal transplant recipient and had been treated with cyclosporine (ciclosporin) for 9 years. A biopsy from the asymptomatic, yellowish papule on the face showed sebaceous gland hyperplasia, and biopsies from the lesions on the nose revealed basal cell carcinomas. The lesions on the nose were excised. Sebaceous gland hyperplasia and skin cancers are among the cutaneous neoplasms observed in renal transplant recipients receiving cyclosporine. To our knowledge, this is the third reported case of the coexistence of basal cell carcinomas and multiple sebaceous gland hyperplasias in a cyclosporine-treated renal transplant recipient.

[Sebaceous gland hyperplasia as a side effect of cyclosporin A. Treatment with the CO2 laser]. / Talgdrüsenhyperplasien als Nebenwirkung von Cyclosporin A. Behandlung mit dem CO2-Laser.

HISTORY AND CLINICAL FINDINGS: After renal transplantation 11 years previously followed by immunosuppression with cyclosporin A, a 59-year-old man developed, shortly after starting the medication, skin-coloured nodules in the region of both ears and the forehead. In the subsequent years the skin changes spread throughout the entire face. The nodes (up to 2 cm in diameter) and nodules were soft and yellowish-white in colour. In addition there were numerous distinct telangiectasias over the whole face. INVESTIGATIONS: Several skin biopsies were taken. They showed largely unremarkable epidermis but marked enlargement and multiplication of the sebaceous glands. DIAGNOSIS, TREATMENT AND COURSE: In view of the histological findings the diagnosis of sebaceous hyperplasia was established. After a trial with carbon dioxide laser, treatment over the entire surface of the two auricles was undertaken under full anaesthesia. The normal auricular contour was reconstituted by removal of the papules and nodes, without any scar formation. CONCLUSION: In the absence of an alternative medication and if the very marked skin changes show no sign of regression, "shaving off" by scalpel of the nodes and nodules or conventional surgery has been the available treatment. However, removal by carbon dioxide laser has the advantage of fewer side effect, is less stressful to the patient and provides a dry operative field.