Sirolimus-Induced Rash in a Kidney Transplant Patient

Sirolimus is an inhibitor of the mammalian target of rapamycin, which is used in kidney transplant immunosuppression. The clinical spectrum of cutaneous adverse events associated with sirolimus use varies, with maculopapular rash being an uncommon side effect very rarely reported in the literature. We present the case of a 78-year-old male renal transplant recipient who developed a diffuse maculopapular pruritic rash after starting sirolimus. This case report demonstrates that maculopapular rash is an uncommon sirolimus-related side effect that must be identified promptly so the medication can be discontinued and rash progression prevented. LEARNING POINTS: Acneiform dermatitis, folliculitis, onychopathy, oral ulcers, rash and stomatitis are all common dermatological side effects of sirolimus. The occurrence of a diffuse pruritic maculopapular rash associated with sirolimus use is rare, but an important differential to keep in mind. Sirolimus cessation is required in case of diffuse pruritic maculopapular rash.