|Cutaneous Lesions in Graft
versus Host Disease
Dr Sampurna Roy MD May 2016
Skin biopsy showing the important microscopic features.
Graft versus host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunologically compromised recipients.
(Example- In leukemia, aplastic anaemia and certain immunodeficiency states).
GVHD is one of the most important causes of morbidity and mortality following bone marrow transplantation.
Early acute phase:
Besides the cutaneous lesions, the patient also complains of vomiting, diarrhoea and hepatic dysfuncton.
Cutaneous lesions include:
- Erythematous macular rash.
- Occasionally follicular papules resembling folliculitis.
- In severe cases, erythematous to violaceous scaling lesions and even blisters.
- Very rarely toxic epidermal necrolysis may occur.
Late chronic phase:
1. Early lichenoid phase (both oral and cutaneous lesions clinically resemble lichen planus.
2. Late sclerodermoid phase may be localized or generalized.
Other lesions noted in late phase include esophagitis, liver disease, sicca syndrome, lupus erythematosus-like eruptions, pyogenic granuloma & other angiomatous lesions and alopecia.
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