Lichenoid chronic graft-vs-host disease occurring in a dermatomal distribution

Freemer, C. S.

doi:10.1001/archderm.130.1.70

Cited by 13 publications

(18 citation statements)

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“…47 Linear lesions have been reported both following Blaschko's lines 48 and in a dermatomal distribution. 49,50 Besides lichenoid and sclerodermoid lesions, patients with cGVHD can show clinical and histological lesions resembling ichthyosis vulgaris. [51][52][53] Also hyperpigmentation and vitiliginous depigmentation can be present.…”

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Dijk¹,

Sanders

Verdonck

et al. 2003

Histopathology

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Allogeneic haematopoietic stem cell transplantation (i.e. bone marrow or peripheral blood stem cell transplantation) is a common procedure in the treatment of various haematological disorders such as aplastic anaemia, (pre)leukaemias, some malignant lymphomas, multiple myeloma and immunodeficiency states. Many of these patients develop erythematous skin lesions following transplantation. Although graft- versus-host disease is the major differential diagnosis in these situations, many other causes of erythema are encountered. The large number of transplant patients means that more and more pathologists are confronted with the challenging problem of making a correct diagnosis in these situations. In this review article we therefore describe the different causes of erythema and their differential diagnoses. In most cases the clinical presentation is related to the microscopical features. Besides acute and chronic graft-versus-host disease, we discuss the (common) drug reactions and non-specific features such as Sweet's syndrome, erythema nodosum and eosinophilic folliculitis. In addition, we deal with the recurrence of original diseases and infections. With this knowledge every pathologist should feel comfortable when looking at skin biopsies of patients after haematological stem cell transplantation.

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Section: Introductionmentioning

confidence: 99%

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Dijk¹,

Sanders

Verdonck

et al. 2003

Histopathology

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“…Some authors have postulated that the dermatomal distribution may correspond to that of a previous herpes zoster (1,4). However, in all reported cases, lesions have appeared on previously normal skin with no history of preceding varicella zoster infection (1)(2)(3)(4)(5). We describe a case of linear lichenoid chronic GVHD in the same dermatomal distribution of a previous culture-proven varicella-zoster infection.…”

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confidence: 73%

“…Cases of linear GVHD, of both the lichenoid (2-5) and sclerodermiform (1) variants, have been described. In all, the lesions appeared de novo, on previously normal skin (1)(2)(3)(4)(5). To explain this so-called dermatomal distribution, Freemer et al, (2) proposed an association with a subclinical or previously unrecognized HZV infection.…”

Section: Discussionmentioning

confidence: 99%

“…In all, the lesions appeared de novo, on previously normal skin (1)(2)(3)(4)(5). To explain this so-called dermatomal distribution, Freemer et al, (2) proposed an association with a subclinical or previously unrecognized HZV infection. In bone marrow transplant recipients, subclinical HZV reactivation occurs as commonly as clinically apparent herpes zoster (16).…”

Section: Discussionmentioning

confidence: 99%

“…The skin manifestations of chronic GVHD include lichenoid lesions and/ or sclerodermatous changes. Skin lesions are usually widespread but localized eruptions may occur (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In some cases of localized GVHD, lesions follow a dermatomal (1,2,4) or Blaschko's line pattern (3,5).…”

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confidence: 99%

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Dermatomal lichenoid chronic graft‐vs‐host disease following varicella‐zoster infection despite absence of viral genome

et al. 1996

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Localized cutaneous graft-versus-host disease (GVHD) following a dermatomal distribution or in a pattern of Blaschko's lines. Some authors have postulated that dermatomal GVHD is triggered by a varicella-zoster virus infection, although in reported cases, there was no history of a preceding herpes zoster. We describe a case of GVHD localized to the exact dermatome of a culture-proven varicella-zoster virus infection. PCR analysis failed to detect persistence of viral genome in the affected skin.

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Localization of Sclerotic-type Chronic Graft-vs-Host Disease to Sites of Skin Injury

Martires

Baird²,

Citrin³

et al. 2011

Arch Dermatol

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Background: The mechanisms responsible for the variable manifestations of chronic cutaneous graft-vs-host disease (cGVHD) are poorly understood. Localization of sclerotic-type chronic graft-vs-host disease to sites of skin injury (isomorphic and isotopic responses), a recognized phenomenon in morphea, suggests a potential common pathway between cGVHD and other sclerotic skin conditions. Observations: Four cases of sclerotic-type cGVHD developed at the site of disparate skin injuries (ionizing radiotherapy, repeated needle sticks, central catheter site, and varicella-zoster virus infection). We review the spectrum of previously reported cases of sclerotic and nonsclerotic cGVHD relating to external forces on the skin. Conclusions: Localization of sclerotic-type cGVHD may occur after many types of skin injury, including UV and ionizing radiotherapy, needle sticks, viral infection, and pressure or friction. Recognition of this phenomenon may be helpful for the early diagnosis of sclerotic disease. Recent insights into the immunological consequences of minor skin injury may provide important clues to the underlying pathogenesis of cGVHD-mediated skin disease.

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Lichenoid chronic graft-vs-host disease occurring in a dermatomal distribution

Cited by 13 publications

References 0 publications

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation

Dermatomal lichenoid chronic graft‐vs‐host disease following varicella‐zoster infection despite absence of viral genome

Localization of Sclerotic-type Chronic Graft-vs-Host Disease to Sites of Skin Injury

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