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September 1988

Acute Follicular Graft-vs-Host Disease

Author Affiliations

Department of Dermatology University of Minnesota 420 Delaware St SE Box 98 Minneapolis, MN 55455-0392

Arch Dermatol. 1988;124(9):1442. doi:10.1001/archderm.1988.01670090084023

To the Editor.—  We read with interest the report of Friedman and coworkers on acute follicular graft-vs-host reaction (disease) that appeared in the May issue of the Archives.1 We have also seen this complication of bone marrow transplantation in two of our patients.Both of our patients were men, aged 34 years, who had acute myelogenous leukemia, one with a granulocytic (M2) variant, the other with a monoblastic (M5A) variant. Both patients had failed courses of conventional chemotherapy. They received total body irradiation (8.5 Gy) and high-dose cyclophosphamide therapy (50 mg/kg/d for four consecutive days) prior to receipt of recin-treated autologous bone marrow transplants. Both transplants were complicated by the development of graft-vs-host disease, resulting in adult respiratory distress syndrome and the death of both patients.Clinically, the first manifestation in both of our patients was flat-topped, follicular, dusky, erythematous papules on the buttocks and the backs of the

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