Graft-versus-host disease

Hymes, Sharon R.; Alousi, Amin M.; Cowen, Edward W.

doi:10.1016/j.jaad.2011.11.961

Cited by 78 publications

(10 citation statements)

References 123 publications

(130 reference statements)

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“…Therapeutic options for GVHD are likely to be determined by different relevant factors such as disease classification, overall grading, organs involved, and associated symptoms [ 81 – 84 ]. The importance of an immunological antitumor effect, depending on the patient’s underlying disease and the risk factors involved in GVHD severity, should also be carefully evaluated [ 11 ].…”

Section: Treatmentmentioning

confidence: 99%

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Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment

et al. 2017

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Graft-versus-host disease (GVHD) is an immunological reaction and a frequent complication following allogeneic hematopoietic stem cell transplantation. It is associated with high mortality rates and may have a significant negative impact on the patient’s quality of life, particularly in the chronic-stage setting. Many different organs can be involved, which leads to a wide range of clinical manifestations. In this context, dermatologists play a key role by diagnosing and treating GVHD from the outset since cutaneous features are not just the most common but are also usually the presenting sign. Several skin-direct therapies are available and may be indicated as monotherapy or adjuvant treatment in order to allow faster tapering and withdrawal of systemic immunosuppression. Treatment of steroid-refractory patients remains a challenge and, to date, no consensus has been reached for one single agent in second-line therapy. This article aims to review skin involvement as well as provide and update discussion on therapeutic options for both acute and chronic cutaneous GVHD.

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Section: Treatmentmentioning

confidence: 99%

“…For cutaneous chronic GVHD, several skin-direct therapies are available and may be indicated as monotherapy or as adjuvant treatment for more severe cases in order to allow faster tapering and withdrawal of systemic immunosuppression by improving local responses [ 81 , 84 , 107 – 112 ].…”

Section: Treatmentmentioning

confidence: 99%

Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment

et al. 2017

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Section: Discussionmentioning

confidence: 99%

“…3,7-9 Localized, cutaneous GVHD may respond well to topical steroids or, alternatively, to tacrolimus and pimecrolimus. 7 Although hematopoietic cell transplanted patients are counseled to avoid ultraviolet radiation due to possible GVHD flare or increased risk of skin cancer, psoralens plus ultraviolet A light (PUVA) or narrow band-ultraviolet B phototherapy are the choice for the treatment of sclerotic cGVHD lesions. 7-9 It is also important to have in mind that these patients have increased risk of secondary malignancies of the skin or mucosa including squamous cell carcinoma and melanoma, therefore dermatological screenings are recommended throughout life.…”

Section: Discussionmentioning

confidence: 99%

Chronic graft-versus-host disease: clinical presentation of multiple lesions of lichenoid and atrophic pattern

Vasconcelos

Vieira

Minicucci

et al. 2013

An. Bras. Dermatol.

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Graft-versus-host disease is observed mainly in recipients of hematopoietic cell transplantation and is expressed by cutaneous or systemic signals and symptoms. Graft-versus-host disease is clinically classified as acute or chronic. Chronic Graft-versus-host disease occurs in up to 70% of hematopoietic cell transplanted patients and its clinical manifestations have important impact on morbidity and quality of life. The authors report an expressive cutaneous, oral and adnexal involvement in a patient with chronic Graft-versus-host disease with multiple lesions of lichenoid and atrophic pattern.

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“…1 Although distinctive, the cutaneous manifestations of chronic GVHD (cGVHD) are also more diverse and frequently pose a treatment challenge as effective therapies are limited. 2,3 Manifestations of chronic GVHD range from superficial cutaneous involvement including dyspigmentation and lichenoid disease to deep involvement including dermal or fascial fibrosis resembling systemic sclerosis and eosinophilic fasciitis, respectively. An uncommon cutaneous presentation of cGVHD is “eruptive angiomas,” a manifestation that is rarely reported, poorly understood, and challenging to treat.…”

mentioning

confidence: 99%

Graft-versus-host disease-associated angiomatosis: A clinicopathologically distinct entity

Kaffenberger

Zuo

Gru

et al. 2014

Journal of the American Academy of Dermatology

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Background Chronic graft-versus-host disease (GVHD) may present with various cutaneous manifestations. Isolated case reports describe eruptive angiomas in this setting. Objective To provide a clinical and pathologic description of vascular proliferations in patients with GVHD. Methods Cases of documented GVHD associated with vascular proliferations were collected from the National Institutes of Health, Ohio State University, and MD Anderson Cancer Center. Results 11 patients with a diagnosis of GVHD who developed vascular proliferations were identified. All patients manifested sclerotic type chronic GVHD of the skin. Vascular lesions were first documented a median of 44 months after transplant and occurred primarily on the lower extremities or trunk. Histopathology revealed anastomosing networks of thin-walled vascular proliferations in a vague lobular growth pattern, with overlying epidermal acanthosis, peripheral collarette, ulceration, and disorganized fibroblast-rich and fibrotic stroma. Improvement was noted in one patient treated with propranolol and sirolimus and one patient with electrocautery. Limitations Given the retrospective nature of the study, the overall incidence of vascular lesions in patients with GVHD is unknown. Histopathology was present for review on only 3/11 patients. Conclusion: The phenomenon of vascular lesions appears to be relatively specific for sclerotic type chronic GVHD when compared to other fibrosing diseases. We propose the term GVHD-associated angiomatosis to describe this entity.

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Graft-versus-host disease

Cited by 78 publications

References 123 publications

Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment

Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment

Chronic graft-versus-host disease: clinical presentation of multiple lesions of lichenoid and atrophic pattern

Graft-versus-host disease-associated angiomatosis: A clinicopathologically distinct entity

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