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Skin Diseases Associated with Stem Cell Transplantation

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Skin Diseases in the Immunosuppressed

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Abstract

Hematopoietic stem cell transplantation (HSCT) has been used as curative treatment in both children and adults for hematologic malignancies, immunodeficiencies, autoimmune disorders, and other rare indications. While HSCT has revolutionized patient care, following HSCT, patients are at risk for several secondary cutaneous side effects. In this chapter, we discuss indications for HSCT, conditioning regimens before transplantation, and types of HSCTs. While there is a large range of cutaneous sequelae, we focus on three main topics and their histopathologic correlations in order to help practitioners identify them: (1) the different stages of acute and chronic cutaneous graft-versus-host disease as well as available treatment options; (2) the risk of cutaneous malignancies including nonmelanoma skin cancers and melanoma, as well as additional factors which may increase a patient’s risk; and (3) autoimmune and inflammatory skin diseases associated with HSCT. In transplant recipients, the diagnosis and management of acute and chronic skin diseases after HSCT are vital. We recommend full skin examinations annually and appropriate referral to dermatology when needed, especially in patients who may be at higher risk for skin cancer. Continued research is needed to better understand the pathogenesis and treatment of post-transplant effects on the skin.

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Johanna Sheu M.S., Vinod E. Nambudiri M.D., M.B.A. & Jennifer T. Huang M.D.

  2. Dermatology Program, Boston Children’s Hospital, Boston, MA, USA

    Johanna Sheu M.S., Vinod E. Nambudiri M.D., M.B.A. & Jennifer T. Huang M.D.

  3. Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, USA

    Vinod E. Nambudiri M.D., M.B.A.

  4. UT Erlanger Dermatology, Chattanooga, TN, USA

    Allison L. Goddard M.D.

  5. Department of Dermatology, University of Virginia Health System, Charlottesville, VA, USA

    Arturo P. Saavedra M.D., Ph.D., M.B.A.

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  1. Johanna Sheu M.S.
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  2. Vinod E. Nambudiri M.D., M.B.A.
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  3. Allison L. Goddard M.D.
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  4. Jennifer T. Huang M.D.
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Correspondence to Arturo P. Saavedra M.D., Ph.D., M.B.A. .

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  1. Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA

    Oscar R. Colegio

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Sheu, J., Nambudiri, V.E., Goddard, A.L., Huang, J.T., Saavedra, A.P. (2018). Skin Diseases Associated with Stem Cell Transplantation. In: Colegio, O. (eds) Skin Diseases in the Immunosuppressed. Springer, Cham. https://doi.org/10.1007/978-3-319-68790-2_6

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