SEBACEOUS HYPERPLASIA, A SIDE-EFFECT OF C YCLOSPORINE-A, TREATED WITHCARBON-DIOXIDE LASER

History and clinical findings: After renal transplantation 11 years pr eviously followed by immunosuppression with cyclosporin A, a 59-year-o ld man developed, shortly after starting the medication, skin-coloured nodules in the region of both ears and the forehead. In the subsequen t 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 mult iplication of the sebaceous glands. Diagnosis, treatment and course: I n view of the histological findings the diagnosis of sebaceous hyperpl asia was established. After a trial with carbon dioxide laser, treatme nt over the entire surface of the two auricles was undertaken under fu ll anaesthesia. The normal auricular contour was reconstituted by remo val of the papules and nodes, without any scar formation. Conclusion: In the absence of an alternative medication and if the very marked ski n changes show no sign of regression, >>shaving off<< by scalpel of th e nodes and nodules or conventional surgery has been the available tre atment. 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.