Table 1 Immunosuppressive adverse effects scoring system with gastrointestinal and aesthetic adverse effects

Vomiting

    0:

None

    1+:

Minimal vomiting

    2+:

Excessive vomiting requiring symptomatic treatment

Diarrhea

    0:

None

    1+:

One loose bowel movement per day

    2+:

Two to five loose bowel movements per day

Dyspepsia

    0:

None

    1+:

Episode of indigestion within one hour after taking immunosuppressive medication

    2+:

Indigestion for at least half the day

    3+:

Indigestion the majority of the day requiring symptomatic treatment

Acid suppressive therapy

    0:

None

    1+:

Daily use of a histamine-2 receptor antagonist OR a proton pump inhibitor

    2+:

Daily use of a histamine-2 receptor antagonist AND a proton pump inhibitor

Acne

    0:

None

    1+:

Lesion restricted to face, no specific treatment

    2+:

Numerous facial lesions; lesions of upper trunk

    3+:

Grade II and topical treatment

    4+:

Grade II and systemic treatment

Skin changes

    0:

No change

    1+:

No gross change but easy bruising

    2+:

Obvious thinning multiple or frequent ecchymoses

    3+:

Grade II and easy sloughing and/or striae; lacerations

Hirsutism

    0:

None

    1+:

New hair growth anywhere

    2+:

Marked increase in hair growth with noticeable change in appearance

    3+:

Grade II and use of depilatories or shaves

Moon facies

    0:

No change

    1+:

Rounding of jaws barely detected

    2+:

Marked rounding with noticeable change in appearance

    3+:

Grade II with plethora

Gingival hyperplasia

    0:

Absent

    1+:

Some hyperplasia

    2+:

Severe hyperplasia and bleeding

Buffalo hump

    0:

Absent

    1+:

Present