[Eczema-like cutaneous graft versus host disease treated by UV-B therapy in a 2-year-old child].
BACKGROUND
Chronic graft versus host disease (GVHD) has rarely been reported in children. Optimal treatment should minimize infectious complications and preserve the child's growth. We report a case of cutaneous GVHD in a two year-old boy, who presented an eczema-like eruption and responded well to broad band UV-B therapy.


METHODS
A two year-old boy with acute myeloblastic leukemia had a heterologous bone marrow transplantation with a graft issued from an unrelated female donor. Three month later, he developed eczema-like lesions of the trunk, arms and legs associated with diffuse alopecia, despite oral corticosteroids and cyclosporine treatment. Histologic findings were consistent with GVHD. Topical corticosteroids and broad band UV-B therapy were initiated, while oral corticosteroids and cyclosporine doses were tappered off. GVHD lesions cleared, allowing withdrawal of oral corticosteroids and cyclosporine 3 and 12 months respectively after initiation of UV-B therapy. No relapse occurred 24 months after systemic treatment discontinuation and 12 months after broad band UV-B therapy was stopped.


CONCLUSIONS
This observation suggests that broad band UV-B therapy is an effective treatment for eczema-like, cutaneous GVHD.
Tanasescu
S
S
Clinique Dermatologique, CHU de Rouen.
Balguerie
X
X
Thomine
E
E
Boullie
M C
MC
Vannier
J P
JP
Tron
P
P
Joly
P
P
Lauret
P
P
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000008:administration & dosage; D004485:Eczema / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D019520:Living Donors; D008297:Male; D012535:Scalp / Q000473:pathology; D014467:Ultraviolet Therapy
D000305:Adrenal Cortex Hormones; D016572:Cyclosporine