title: Epidermodysplasia verruciformis in the setting of graft-versus-host disease.
abstract: We report a case of epidermodysplasia verruciformis (EV)-like lesions in a patient with graft-versus-host disease after peripheral blood stem cell transplantation from his HLA-matched brother. The patient presented with a diffuse papular eruption that was clinically consistent with graft-versus-host disease; however, histopathology demonstrated viral cytopathic changes and polymerase chain reaction confirmed EV human papillomavirus types 8 and 20. Repeated biopsy specimen showed both human papillomavirus cytopathic effect and graft-versus-host disease, and further workup revealed ocular and hepatic involvement. This progressed to a lupuslike syndrome with lichenoid, violaceous, flat-topped papules in a malar distribution and positive antinuclear autoantibodies. Although EV-like lesions have been reported in patients who are immunocompromised, the incidence is low, and may be linked to EV-related haplotypes.
authors.affiliation: Department of Dermatology, University of Texas-Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Joy H
authors.initials: JH
authors.lastname: Kunishige
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Hymes
authors.forename: Vandana
authors.initials: V
authors.lastname: Madkan
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Wyatt
authors.forename: David
authors.initials: D
authors.lastname: Uptmore
authors.forename: Alexander J F
authors.initials: AJ
authors.lastname: Lazar
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.forename: Peter
authors.initials: P
authors.lastname: Rady
authors.forename: Stephen
authors.initials: S
authors.lastname: Tyring
mesh_terms: D000328:Adult; D004819:Epidermodysplasia Verruciformis / Q000209:etiology* / Q000473:pathology; D006086:Graft vs Host Disease / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology / Q000601:surgery*; D019520:Living Donors; D016393:Lymphoma, B-Cell / Q000150:complications*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000150:complications*; D033581:Stem Cell Transplantation / Q000009:adverse effects*