Acute follicular graft-vs-host reaction. A distinct clinicopathologic presentation.
Human graft-vs-host disease (GVHD) is a life-threatening complication that may occur following allogeneic bone marrow transplantation. In acute GVHD, skin involvement is frequent, and the skin is often the initial organ involved. The rash typically is a blanchable, erythematous macular eruption. We present the first report of follicular cutaneous GVHD. Three patients developed follicular papules simulating bacterial or fungal folliculitis as a major clinical expression of cutaneous involvement in acute GVHD following allogeneic bone marrow transplantation. In each case, histopathologic examination demonstrated features of acute graft-vs-host reaction involving hair follicles. This suggests that follicular epithelium may be an early target in acute GVHD.
Friedman
K J
KJ
Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
LeBoit
P E
PE
Farmer
E R
ER
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D003937:Diagnosis, Differential; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D006201:Hair Diseases / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D011379:Prognosis; D012871:Skin Diseases / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*