To the Editor.—
In the November 1985 issue of the Archives, Ling et al1 describe a girl with dyskeratosis congenita (DCG) simulating chronic graft-vs-host disease (GVHD) and aptly compare and contrast the two conditions. It should be noted, however, that contrary to the statement in their Table 2 (features of DCG and chronic GVHD), nail dystrophy may be a manifestation of chronic GVHD.2-6 The similarity of the nail changes in the two conditions can be appreciated in the accompanying photograph. The Figure, top, depicts the nail dystrophy in a 6½-year-old boy with DCG who has oral and lingual leukokeratosis and erosions, gray-brown reticulated hyperpigmentation of the groin, lower abdomen, and axillary areas, and pancytopenia. The Figure, bottom, demonstrates the nail dystrophy in a 4-year-old boy with acute myelomonocytic leukemia, treated two years previously by bone marrow transplant, who has documented chronic late-stage GVHD. The nail changes developed concurrent with alopecia and
Esterly NB. Nail Dystrophy in Dyskeratosis Congenita and Chronic Graft-vs-Host Disease. Arch Dermatol. 1986;122(5):506–507. doi:10.1001/archderm.1986.01660170030012
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