Nellen Ruud G L, van Marion Arienne M W, Frank Jorge, Poblete-Gutiérrez Pamela, Steijlen Peter M
Department of Dermatology, Maastricht University Medical Center, The Netherlands.
Int J Dermatol. 2008 Nov;47 Suppl 1:32-4. doi: 10.1111/j.1365-4632.2008.03956.x.
Maculopapular exanthemas have a particular high incidence among patients treated with autologous hematopoietic stem cell transplantation (HSCT). In most cases, a viral or drug induced origin is easily identified. However, the transplantation itself may also induce similar skin changes. These exanthemas are known under various names, such as autologous graft-versus-host disease (GVHD), engraftment syndrome (ES) or eruption of lymphocyte recovery (ELR). Given the clinical and histopathological similarities of these disorders, it can prove difficult to establish a diagnosis. Here, we describe a patient who developed a maculopapular exanthema after autologous stem cell transplantation for multiple myeloma, diagnosed as autologous GVHD. We also briefly review the current knowledge of the pathogenesis of autologous GVHD, ES, and ELR. Based on these data we would like to suggest that the latter two do not reflect own disease entities but rather different presentations of autologous GVHD.
斑丘疹性皮疹在接受自体造血干细胞移植（HSCT）治疗的患者中发病率特别高。在大多数情况下，病毒或药物引起的病因很容易确定。然而，移植本身也可能诱发类似的皮肤变化。这些皮疹有各种名称，如自体移植物抗宿主病（GVHD）、植入综合征（ES）或淋巴细胞恢复性皮疹（ELR）。鉴于这些疾病在临床和组织病理学上的相似性，可能难以做出诊断。在此，我们描述了一名在自体干细胞移植治疗多发性骨髓瘤后出现斑丘疹性皮疹的患者，诊断为自体GVHD。我们还简要回顾了目前关于自体GVHD、ES和ELR发病机制的知识。基于这些数据，我们认为后两者并非独立的疾病实体，而是自体GVHD的不同表现形式。
