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April 2018

Blaschkoid Acute Graft-vs-Host Disease

Author Affiliations
  • 1Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
  • 2Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
JAMA Dermatol. 2018;154(4):494-495. doi:10.1001/jamadermatol.2017.6023

We describe a patient who developed an eruption of acute graft-vs-host disease (GVHD) along the lines of Blaschko following a bone marrow transplant, an uncommon manifestation that raises other clinical possibilities and presents a diagnostic challenge.

A 10-year-old boy presented with an itchy erythematous eruption of 1 week’s duration confined to the right side of his body and preceded by watery diarrhea for a few days. He had been diagnosed with B-cell, acute, lymphoblastic leukemia 3 years earlier and had been treated with high-dose chemotherapy. He relapsed after initial remission and received chemotherapy again, leading to another remission. During this second remission, and 1 month prior to current presentation, he underwent an allogenic bone-marrow transplant. His medications included cyclosporine A, 100 mg/d, acyclovir, and cotrimoxazole.