Advertisement

Clinical Presentation of Acute Cutaneous Graft-Versus-Host Disease

  • Jonathan A. CotliarEmail author
Chapter

Abstract

Acute cutaneous graft-versus-host disease (aGVHD) has a variety of clinical presentations. In the early posttransplantation setting, histologic confirmation of aGVHD via skin biopsy is frequently equivocal. Additional clinical information may be necessary to differentiate aGVHD from its clinical mimickers such as viral exanthema, morbilliform drug eruptions, engraftment syndrome (ES), pre-engraftment syndrome (PES), and in severe cases, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) [1–3].

Keywords

Acute graft-versus-host disease aGVHD Hematopoietic stem cell transplantation HSCT 

References

  1. 1.
    Ziemer M, Haeusermann P, Janin A, Massi D, Ziepert M, Wolff D, et al. Histopathological diagnosis of graft-versus-host disease of the skin: an interobserver comparison. J Eur Acad Dermatol Venereol. 2014;28:915–24.CrossRefPubMedGoogle Scholar
  2. 2.
    Byun HJ, Yang JI, Kim BK, Cho KH. Clinical differentiation of acute cutaneous graft-versus-host disease from drug hypersensitivity reactions. J Am Acad Dermatol. 2011;65:726–32.CrossRefPubMedGoogle Scholar
  3. 3.
    Mays SR, Kunishige JH, Truong E, Kontoyiannis DP, Hymes SR. Approach to the morbilliform eruption in the hematopoietic transplant patient. Semin Cutan Med Surg. 2007;26:155–62.CrossRefPubMedGoogle Scholar
  4. 4.
    Hymes SR, Alousi AM, Cowen EW. Graft-versus-host disease: part I. Pathogenesis and clinical manifestations of graft-versus-host disease. J Am Acad Dermatol 2012;66:515.e1–18; quiz 533–4.Google Scholar
  5. 5.
    Friedman KJ, LeBoit PE, Farmer ER. Acute follicular graft-vs-host reaction. A distinct clinicopathologic presentation. Arch Dermatol. 1988;124:688–91.CrossRefPubMedGoogle Scholar
  6. 6.
    Cornejo CM, Kim EJ, Rosenbach M, Micheletti RG. Atypical manifestations of graft-versus-host disease. J Am Acad Dermatol. 2015;72:690–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Macedo FI, Faris J, Lum LG, Gabali A, Uberti JP, Ratanatharathorn V, White MT. Extensive toxic epidermal necrolysis versus acute graft versus host disease after allogenic hematopoietic stem-cell transplantation: challenges in diagnosis and management. J Burn Care Res. 2014;35:e431–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Arvidson J, Kildal M, Linde T, Gedeborg R. Toxic epidermal necrolysis and hemolytic uremic syndrome after allogeneic stem-cell transplantation. Pediatr Transplant. 2007;11:689–93.CrossRefPubMedGoogle Scholar
  9. 9.
    Correia O, Delgado L, Barbosa IL, Domingues JC, Azevedo R, Vaz CP, Pimentel P. CD8+ lymphocytes in the blister fluid of severe acute cutaneous graft-versus-host disease: further similarities with toxic epidermal necrolysis. Dermatology. 2001;203:212–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Dermatology, Department of SurgeryCity of Hope National Medical CenterDuarteUSA

Personalised recommendations