Acquired digital fibrokeratoma associated with ciclosporin treatment

Abstract

Conflict of interest: none declared. Ciclosporin (CsA) is the favoured drug for immunosuppressive treatment in recipients of organ transplants. The principal adverse reactions to CsA treatment are renal dysfunction, tremor, hirsutism, hypertension and gingival overgrowth. We report a case of acquired digital fibrokeratoma (ADFK) and concomitant gingival overgrowth secondary to CsA treatment in a renal‐transplant recipient. A 39‐year‐old Chinese woman presented with two gradually enlarging tumours on the left great toe and with gingival overgrowth, which had been present for 2 years. The patient had received a renal transplant 6 years previously and was taking CsA. Physical examination found two solitary, skin‐coloured, firm tumours under the lateral nail folds of the left great toe. One of the tumours was verrucous and slightly erosive and about 12 × 8 × 7 mm3 in size. The other was a tall finger‐like protrusion with a hyperkeratotic surface, about 4 × 3 × 6 mm3 in size (Fig. 1). Diffuse waxy nodules and masses were present on the upper and lower gingiva (Fig. 2).