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April 17, 2019

Decoding Skin Involvement in Chronic Graft-vs-Host Disease

Author Affiliations
  • 1Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland
JAMA Dermatol. 2019;155(7):777-778. doi:10.1001/jamadermatol.2019.0354

The role of dermatologists in the care of patients with graft-vs-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation varies greatly. In the acute inpatient setting, we are typically called on to perform a “diagnostic” skin biopsy of a nonspecific exanthem, but systemic management may be deferred to the primary transplant team. In the chronic setting, the skin features of GVHD are highly polymorphic and include papulosquamous eruptions, alopecia, dyspigmentation, pruritus, edema, sclerosis, fasciitis, bullae, or ulceration. Given these protean skin manifestations, ideally dermatologists should play an active role in the diagnosis and management of chronic GVHD as part of a multidisciplinary care team.