title: Acute follicular graft-vs-host reaction. A distinct clinicopathologic presentation.
abstract: 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.
authors.affiliation: Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
authors.forename: K J
authors.initials: KJ
authors.lastname: Friedman
authors.forename: P E
authors.initials: PE
authors.lastname: LeBoit
authors.forename: E R
authors.initials: ER
authors.lastname: Farmer
mesh_terms: 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*