title: German-Austrian-Swiss Consensus Conference on clinical practice in chronic graft-versus-host disease (GVHD): guidance for supportive therapy of chronic cutaneous and musculoskeletal GVHD.
abstract: Supportive therapy plays a central role in the management of cutaneous and musculoskeletal manifestations of chronic graft-versus-host disease (cGVHD), either alone or in combination with systemic approaches. We present results from the German-Austrian-Swiss Consensus Conference on clinical practice in cGVHD, held in Regensburg, Germany, in November 2009. The intention was to achieve a consensus on current evidence-based treatment options as well as to provide guidelines for daily clinical practice. Skin is the most common organ involved in cGVHD. Its clinical presentation varies considerably. Patients may have pruritus, rash, pain, dyspigmentation and fibrotic or sclerodermatous lesions, often leading to contractures. Treatment options for supportive therapy in cutaneous cGVHD include topical therapies such as topical steroids and topical calcineurin inhibitors, as well as phototherapy and physiotherapy. The most relevant manifestation in musculoskeletal cGVHD is fasciitis which must be distinguished from sclerodermatous skin cGVHD. Physiotherapy is the mainstay of supportive treatment in fasciitis in cGVHD. Successful therapy of cutaneous and musculoskeletal cGVHD depends on interdisciplinary management to improve patients' quality of life.
authors.affiliation: Department of Oncology, Hematology and Stem Cell Transplantation, Internal Medicine I, University Medical Center Freiburg, 79106 Freiburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Marks
authors.forename: M
authors.initials: M
authors.lastname: Stadler
authors.forename: P
authors.initials: P
authors.lastname: Häusermann
authors.forename: D
authors.initials: D
authors.lastname: Wolff
authors.forename: S
authors.initials: S
authors.lastname: Buchholz
authors.forename: G
authors.initials: G
authors.lastname: Stary
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Lawitschka
authors.forename: H
authors.initials: H
authors.lastname: Bertz
mesh_terms: D001317:Austria; D002908:Chronic Disease; D004643:Emollients / Q000627:therapeutic use; D005858:Germany; D006086:Graft vs Host Disease / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009140:Musculoskeletal Diseases / Q000628:therapy*; D012871:Skin Diseases / Q000517:prevention & control / Q000628:therapy*; D013557:Switzerland; D014467:Ultraviolet Therapy
chemical_list: D004643:Emollients; D007166:Immunosuppressive Agents