Sclerodermatous Graft-vs-Host Disease

Peñas, Pablo F.; Jones‐Caballero, María; Aragüés, Maximiliano; Fernández‐Herrera, Jesús; Fraga, Javier; García‐Diez, Amaro

doi:10.1001/archderm.138.7.924

Cited by 96 publications

(44 citation statements)

References 39 publications

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“…Sclerodermatous cGVHD has the most severe skin involvement and appears late in the course of the disease [1]. It has been described in small series of patients [1][2][3]5]. In our study, the rate of sclerodermatous cGVHD among all surviving patients was similar (5.2%) to previously reported (3.4-3.6%) studies [2,3] but lower than in the study of Skert et al (10.5%) [5].…”

Section: Discussionsupporting

confidence: 82%

“…It has been described in small series of patients [1][2][3]5]. In our study, the rate of sclerodermatous cGVHD among all surviving patients was similar (5.2%) to previously reported (3.4-3.6%) studies [2,3] but lower than in the study of Skert et al (10.5%) [5]. Sclerotic lesions of our patients developed after a mean of 752±647 days (median 480, range: 3 months -5 years).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical diagnosis of cGVHD was established by a dermatologist and the diagnosis of cutaneous sclerodermatous GVHD was established based on both clinical and dermatopathological findings. Pigmentation changes like widespread, well-demarcated, hyperpigmented macules (leopard skin-like pigmentary changes) [2], areas of hypopigmentation, depigmentation, poikiloderma (atrophic and pigmentary changes), lichen sclerosus-like lesions (discrete to coalescent gray to white movable papules and plaques), keratosis pilaris, and ichthyosis were also evaluated. Presence of Raynaud phenomenon, sclerodactyly, and esophageal, joint and/or lung involvement was noted.…”

Section: Methodsmentioning

confidence: 99%

“…The development of acute and chronic graft-versus-host disease (aGVHD, cGVHD) after allogeneic hematopoietic stem cell transplantation (AHSCT) remains a major clinical problem associated with significant morbidity and mortality [1,2]. The skin, gastrointestinal tract and liver are the organs primarily affected [3].…”

Section: Introductionmentioning

confidence: 99%

“…cGVHD can occur anytime from months to years after AHSCT and may or may not be preceded by episodes of aGVHD. Lichenoid and sclerodermatous changes have been described [2][3][4][5][6]. Sclerodermatous cGVHD is distinguished by plaques of dermal sclerosis resembling morphea, and eventually by generalized scleroderma, often resulting in joint contractures [1][2][3][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical aspects of sclerodermatous type graft-versus-host disease after allogeneic hematopoietic cell transplantation

Şanlı¹,

Akay

Soydan³

et al. 2010

Turk J Hematol

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Objective: We aimed to evaluate the clinical features of sclerodermatous chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (AHSCT). Materials and Methods:We retrospectively analyzed 423 patients who underwent AHSCT. We assessed age, sex, pretransplant diagnosis, conditioning regimen, GVHD prophylaxis, and occurrence of acute GVHD (aGVHD), chronic lichenoid and chronic systemic GVHD, and clinical properties of sclerodermatous GVHD. Results: Sclerotic skin lesions developed in 22 patients after a mean of 752±647 days (median 480). aGVHD appeared in 17 patients, with hepatic involvement in 2, gastrointestinal tract involvement in 2 and skin involvement in 13 of these patients. Extensive chronic GVHD (liver, pulmonary, skin and oral mucosa) developed in 12 patients. Sclerosis was generalized in 19 patients (86.4%) and localized in 3 patients (13.6%). Leopard skin eruption appeared in 8 (36.4%) of the 19 patients with generalized sclerodermatous changes. In most cases, sclerotic lesions appeared on the trunk, and distal parts of the extremities were spared. Eight patients (36.4%) progressed from lichenoid to sclerodermatous lesions, 2 (9.1%) with lichenoid and sclerodermatous phases together and 12 (55.5%) with de novo sclerodermatous lesions. Five patients died because of late transplant-related complications. Conclusion: Sclerodermatous GVHD has a late onset and may be quite disabling. Unlike scleroderma, acral involvement is seen rarely. Although most lesions do not disappear in the course of the disease, most patients have a good prognosis. (Turk J Hematol 2010; 27: 91-8)

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