Koebnerizing sclerodermatous graft-versus-host disease caused by donor lymphocyte infusion and interferon-<i>α</i>

White, Jennifer; Devereux, Stephen; Pagliuca, Antonio; Salisbury, Jonathan R.; Vivier, W P du; Creamer, Daniel

doi:10.1111/j.1365-2133.2006.07404.x

Cited by 13 publications

(6 citation statements)

References 12 publications

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“…Interestingly, in our patient, autoimmune reactions ranging from thyroid dysfunctions to sclerodermoid GVHD‐like lesions appeared 1–4 years after the onset of DIHS, a time frame that is similar to chronic GVHD. Although the sclerodermoid GVHD has some similarities to systemic sclerosis, some major differences should be noted 8–10 . Clinically, hyperpigmented lesions and atrophy of the lesions are more common in sclerodermoid GVHD than in systemic scleroderma; xerosis and ichthyosiform changes are more often seen in sclerodermoid GVHD.…”

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confidence: 99%

Sclerodermoid graft-versus-host disease-like lesions occurring after drug-induced hypersensitivity syndrome

2007

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referred, 13 cases should have been coded 2 and eight cases should have been coded 1. There were 43 cases coded 1 or 2 and in one of these the dermatologist felt it should have been coded 3. Further breakdown of the figures showed that: 1 In 67 cases, both the nurse and dermatologist were in agreement over the code. The nurse gave the same diagnosis as the dermatologist in 60 of these cases. 2 The CNS thought that 34 cases were malignant and the dermatologist agreed in 26 of these.After a period of experiential learning and competency achievement the CNS made the safe protocol-driven decision in 101 out of 102 cases. She made the same clinical diagnosis as the dermatologist in 70% of cases but in those cases where the diagnosis differed it would never have led to omission to treat a significant lesion.The most important distinction was between both 1 or 2 (nonworrying lesions) and 3 (potentially malignant). She erred on the side of caution and there was only one case in which a dermatologist had concern (code 3) but the CNS did not (code 1). Later histology revealed this to be a benign junctional naevus. A dermatology CNS working in the manner described can achieve high rates of safe triage as well as forming an accurate diagnosis and carrying out a management plan. Our nurse specialist has made a significant contribution in sharing the workload of new patient referrals to the department and her work brings in an income of £70,000 per annum for the Trust. Although the circumstances may not be easily transferable to other units, we feel that the time invested in the competency framework has brought benefits to patients and the organization. References 1 Cox NH. The expanding role of nurses in surgery and prescribing in British departments of dermatology. Br J Dermatol 1999; 140:681-4. 2 Godsell G. A nurse-surgical post cuts waiting times and extends nurses' skills base. Prof Nurse 2004; 19:453-5. 3 Peters J. Combining nursing roles in dermatology. Prof Nurse 1999; 15:91-4. 4 Cork MJ, Britton J, Butler L et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 2003; 149:582-9. 5 Brown MH. A nurse-led clinic in chronic and allergic contact dermatitis. Br J Nurse 2005; 14:260-3.

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confidence: 99%

Sclerodermoid graft-versus-host disease-like lesions occurring after drug-induced hypersensitivity syndrome

2007

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“…The patients include other men with waistband-associated chronic GVHD and women with brassiere band and/or waistband-related chronic GVHD [1, 2, 11, 14]; of note, similar to the reported patient with isomorphic (waistband) and idiopathic (right forearm and hand) sclerotic-type GVHD, other individuals with concurrent isomorphic chronic cutaneous GVHD and idiopathic sclerotic-type GVHD have been observed [11]. The source of injury associated with isomorphic sclerotic-type GVHD has also been the sites of injections of subcutaneous interferon alpha on the abdomen [15], previous subclavian or central venous catheter placement without [14] or with [11] subsequent cellulitis, repeated needle sticks to obtain blood from the right antecubital fossa [11], suction blisters [16], and Bacillus Calmette Guerin therapy [16]. In addition, chronic GVHD with sclerotic-type skin lesions has been observed to occur at the healed sites of prior acute GVHD [16, 17].…”

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confidence: 63%

Isomorphic Sclerotic-Type Cutaneous Chronic Graft-Versus-Host Disease: Report and Review of Chronic Graft-Versus-Host Disease in a Cutaneous Immunocompromised District

Cohen

2013

Dermatol Ther (Heidelb)

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BackgroundPatients who have received a hematopoietic cell transplantation can develop graft-versus-host disease (GVHD). The liver, the gastrointestinal tract, and/or the skin can be affected by GVHD. Chronic sclerotic-type cutaneous GVHD can occur at sites of repetitive skin friction.PurposeTo describe isomorphic sclerotic-type GVHD and review chronic GVHD appearing in a cutaneous immunocompromised district.MethodsThe clinical features of a 74-year-old man with mantle cell lymphoma who developed chronic sclerotic-type cutaneous GVHD localized to the waistband area—which had been exposed to repetitive skin injury—after a second hematopoietic cell transplantation are reported. Using the PubMed database, an extensive literature search was performed on chronic GVHD.Case report and reviewThe cutaneous immunocompromised district is an area of skin whose local effective immunity has been altered, thereby permitting the development of a dysimmune reaction, infection, or tumor at the site. A cutaneous isomorphic response refers to a disease-associated skin lesion occurring at the site of physical injury that is morphologically similar to the existing condition. Cutaneous chronic GVHD can occur at sites of repetitive skin trauma as an isomorphic response. The patient developed sclerotic-type GVHD in a cutaneous area that had previously experienced repeated irritation, friction, and pressure. Isomorphic sclerotic-type GVHD—in either the waistband area or brassiere area or both—has also been observed in other patients. In addition, cutaneous chronic GVHD has been described not only at the location of a previous, unrelated, and healed skin disease as an isotopic response, but also at the cutaneous site of earlier exposure to radiotherapy or ultraviolet radiation as an isoradiotopic response.ConclusionSclerotic and nonsclerotic skin lesions of chronic GVHD can occur not only as an isomorphic response, but also as either an isotopic response or an isoradiotopic response in a cutaneous immunocompromised district.

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“…In de novo late-onset type, chronic GVHD occurs without prior onset of acute GVHD (4). In spite of such precise classifications, articles describing clinical aspects of morphea-like or localized sclerodermatous GVHD are limited (4)(5)(6)(7). According to Peñas et al (6), who described 5 patients w ith localized sclerodermatous GVHD, mean onset of chronic GVHD was 581 days (range 299-1001 days).…”

Section: Discussionmentioning

confidence: 97%

Multiple Morphea-like lesions Associated with Chronic Graft-versus-host Disease after Cord Blood Transplantation

Kawakami¹,

Ohtsuka

Kikuta

et al. 2009

Acta Derm Venerol

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Koebnerizing sclerodermatous graft-versus-host disease caused by donor lymphocyte infusion and interferon-α

Cited by 13 publications

References 12 publications

Sclerodermoid graft-versus-host disease-like lesions occurring after drug-induced hypersensitivity syndrome

Sclerodermoid graft-versus-host disease-like lesions occurring after drug-induced hypersensitivity syndrome

Isomorphic Sclerotic-Type Cutaneous Chronic Graft-Versus-Host Disease: Report and Review of Chronic Graft-Versus-Host Disease in a Cutaneous Immunocompromised District

Multiple Morphea-like lesions Associated with Chronic Graft-versus-host Disease after Cord Blood Transplantation

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