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May 1988

Acute Follicular Graft-vs-Host Reaction: A Distinct Clinicopathologic Presentation

Author Affiliations

From the Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore (Drs Friedman and Farmer); and the Departments of Dermatology and Pathology, University of California School of Medicine at San Francisco (Dr LeBoit).

Arch Dermatol. 1988;124(5):688-691. doi:10.1001/archderm.1988.01670050032014

• Human graft-vs-host disease (GVHD) is a life-threatening complication that may occur following allogeneic bone marrow transplantation. In acute GVHD, skin involvement is frequent, and the skin is often the initial organ involved. The rash typically is a blanchable, erythematous macular eruption. We present the first report of follicular cutaneous GVHD. Three patients developed follicular papules simulating bacterial or fungal folliculitis as a major clinical expression of cutaneous involvement in acute GVHD following allogeneic bone marrow transplantation. In each case, histopathologic examination demonstrated features of acute graft-vs-host reaction involving hair follicles. This suggests that follicular epithelium may be an early target in acute GVHD.

(Arch Dermatol 1988;124:688-691)

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