Acquired epidermodysplasia verruciformis (AEV) in three children after cardiac transplantation: A case series and review of the literature

Abstract

Acquired epidermodysplasia verruciformis (AEV) describes epidermodysplasia verruciformis developing in an immunocompromised host. There is limited information in the literature regarding AEV in the pediatric population; of the patients reported, most patients described had HIV, with only two reported cases of children who developed AEV post-transplantation. This case series describes three pediatric patients who developed AEV on immunosuppressant therapy following cardiac transplantation. We review risk factors, treatment options, and prognosis of AEV in the pediatric population.

Nonpruritic hypopigmented macules on an immunocompromised patient

“…2 Other treatments include glycolic acid 15%, 2,7 combination therapy involving glycolic acid and imiquimod, 1,2,5 highdose oral cimetidine, and interferon. 3,7 In our case, dosage of acitretin 25 mg three times weekly (Monday, Wednesday, Friday) was started. Upon follow-up 3 months after initiating acitretin, the patient noted improvement.…”

“…Histological findings include epidermal acanthosis, hyperkeratosis, and enlarged cells with bluish-gray cytoplasm and cleared out nuclei, perinuclear halos, and variably prominent keratohyalin granules. 1 , 2 , 3 Epidermodysplasia verruciformis is a condition that can be inherited or acquired. In the acquired form, it affects patients with deficient cell-mediated immunity due to infection (eg, HIV), malignancy, medications, or organ transplantation.…”

Prevalence and spectrum of infectious and inflammatory dermatologic conditions occurring in pediatric heart transplant patients on a predominantly mTOR‐based immune suppressive regimen: A retrospective chart review

“…3 However, patients may experience a plethora of non-cancer-related dermatologic conditions that can cause significant medical and psychosocial morbidity, such as cutaneous infections, inflammatory conditions, and drug eruptions. [4][5][6] Beyond small series and case reports, non-malignant cutaneous conditions are not well studied in the pediatric heart transplant population.…”

“…Pediatric heart transplant patients are routinely followed in dermatology clinics for skin cancer surveillance exams due to their elevated risk of cutaneous malignancy 3 . However, patients may experience a plethora of non‐cancer‐related dermatologic conditions that can cause significant medical and psychosocial morbidity, such as cutaneous infections, inflammatory conditions, and drug eruptions 4–6 . Beyond small series and case reports, non‐malignant cutaneous conditions are not well studied in the pediatric heart transplant population.…”