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March 1995

Lichenoid Graft-vs-Host Disease in an Autologous Bone Marrow Transplant Recipient

Author Affiliations

From the Departments of Dermatology (Drs Martin and Farmer) and Oncology (Ms Altomonte and Drs Vogelsang and Santos), The Johns Hopkins University School of Medicine, Baltimore, Md. Drs Martin and Farmer are now with the Cutaneous Pathology and Immunofluorescence Laboratory, Beachwood, Ohio, and the Indiana University School of Medicine, Indianapolis, respectively.

Arch Dermatol. 1995;131(3):333-335. doi:10.1001/archderm.1995.01690150097019

Background:  Graft-vs-host disease (GVHD) represents one of the major complications of allogeneic bone marrow transplantation (BMT) but is less common in autologous BMT. Following autologous BMT, chronic GVHD has been reported in only four patients, all of whom had a self-limited sclerodermoid form. Lichenoid chronic GVHD has not been previously reported in an autologous BMT patient.

Observations:  Mucosal and cutaneous lichenoid lesions and histologic findings compatible with chronic lichenoid GVHD developed in a patient 35 days after autologous BMT was performed. The onset of clinical lesions at 35 days after BMT is not incongruent with the diagnosis of chronic lichenoid GVHD (rather than a graft-vs-host reaction) and may have been augmented by cyclosporin A in a manner similar to animal model experiments.

Conclusion:  All forms of GVHD can and do occur following autologous BMT.(Arch Dermatol. 1995;131:333-335)