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Acute and Chronic Graft-Versus-Host Disease of the Skin

  • Hasan Khosravi
  • Anar Mikailov
  • Jennifer T. HuangEmail author
Chapter
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Abstract

Graft-versus-host disease (GVHD) is one of the most challenging diseases to diagnose and manage in both children and adults. Despite significant research and advances, GVHD remains a significant cause of morbidity and mortality in the post-hematopoietic stem cell transplant population. Given that skin is the most common organ affected in both acute and chronic forms of GVHD, it is imperative for dermatologists not only to recognize cutaneous manifestations but also to familiarize themselves with first-line therapies for these conditions. In this chapter, we describe four unique cases of acute and chronic GVHD, and discuss the differential diagnosis, diagnostic pearls, and therapeutic approach to these diseases. We begin with a case of classic acute GVHD, and review characteristic clinical features, risk factors, differential diagnosis, and first-line therapies. We then move on to a rare case of toxic epidermal necrolysis-like acute GVHD and discuss second- and third-line agents for treatment-refractory disease, including interventions that saved the patient’s life. In case 3, we transition to a discussion of chronic GVHD, and present a patient with sclerotic disease, reviewing clinical features, risk factors, and first-line therapies for this condition. Lastly, we conclude our chapter with a discussion of an atypical nonsclerotic form cutaneous chronic GVHD associated with a good prognosis.

Keywords

Graft-versus-host disease Pediatric graft-versus-host disease Hematopoietic stem cell transplant Bone marrow transplant GVHD Acute GVHD Chronic GVHD 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Hasan Khosravi
    • 1
  • Anar Mikailov
    • 2
  • Jennifer T. Huang
    • 3
    Email author
  1. 1.Harvard Medical SchoolBostonUSA
  2. 2.Harvard Combined Medicine-Dermatology Residency ProgramBostonUSA
  3. 3.Dermatology ProgramBoston Children’s Hospital, Harvard Medical SchoolBostonUSA

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