Ann Dermatol.  2009 Aug;21(3):319-322. 10.5021/ad.2009.21.3.319.

A Case of Chronic Cutaneous Graft Versus Host Disease with the Clinical Features of Exfoliative Dermatitis

• Ahn HS
• Park HJ
• Lee JY
• Cho BK

• KMID: 2266302
• DOI: http://doi.org/10.5021/ad.2009.21.3.319

Abstract

Graft versus host disease (GVHD) has traditionally been divided into acute GVHD and chronic GVHD based on the period it occurs after transplantation. Chronic cutaneous GVHD has traditionally been classified into the lichenoid and scleroderma-like forms. However, unusual clinical forms have been reported such as dermatomyositis, lupus erythematosus and exfoliative dermatitis. A 35-year-old woman presented with a 2 week history of a pruritic maculopapular rash on the whole body. The rash rapidly progressed to confluent erythematous scaly patches and plaques with micaceous scales and this finally led to a generalized exfoliative dermatitis in a 1 month period. Here we present an unusual case of chronic cutaneous GVHD with the clinical features of exfoliative dermatitis. The histopathologic examination demonstrated the lichenoid features of chronic cutaneous GVHD.

Keyword

Chronic graft versus host disease; Exfoliative dermatitis

MeSH Terms

Adult
Dermatitis, Exfoliative
Dermatomyositis
Exanthema
Female
Graft vs Host Disease
Humans
Transplants
Weights and Measures

Figure

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  Fig. 1 Disseminated maculopapular exanthema on the upper extremities.

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  Fig. 2 The histological findings of the lesion showed basal vacuolization, necrotic epidermal cells and lymphocytes in the dermis, and this was all consistent with the diagnosis of acute cutaneous GVHD, grade II (H&E, A: ×100, B: ×200).

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  Fig. 3 Widespread, pruritic confluent erythematous scaly patches and plaques with micaceous scales on the extremities.

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  Fig. 4 The histological finding of the lesion showed hypergranulosis, acanthosis, necrotic keratinocytes, vacuolar alteration of the basal layer and perivascular inflammatory cell infiltration with a faint band-like pattern (H&E, A: ×40, B: ×100).

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