Martires Kathryn J, Baird Kristin, Citrin Deborah E, Hakim Fran T, Pavletic Steven Z, Cowen Edward W
Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr, Bethesda, MD 20892, USA.
Arch Dermatol. 2011 Sep;147(9):1081-6. doi: 10.1001/archdermatol.2011.226.
The mechanisms responsible for the variable manifestations of chronic cutaneous graft-vs-host disease (cGVHD) are poorly understood. Localization of sclerotic-type chronic graft-vs-host disease to sites of skin injury (isomorphic and isotopic responses), a recognized phenomenon in morphea, suggests a potential common pathway between cGVHD and other sclerotic skin conditions.
Four cases of sclerotic-type cGVHD developed at the site of disparate skin injuries (ionizing radiotherapy, repeated needle sticks, central catheter site, and varicella-zoster virus infection). We review the spectrum of previously reported cases of sclerotic and nonsclerotic cGVHD relating to external forces on the skin.
Localization of sclerotic-type cGVHD may occur after many types of skin injury, including UV and ionizing radiotherapy, needle sticks, viral infection, and pressure or friction. Recognition of this phenomenon may be helpful for the early diagnosis of sclerotic disease. Recent insights into the immunological consequences of minor skin injury may provide important clues to the underlying pathogenesis of cGVHD-mediated skin disease.
慢性皮肤移植物抗宿主病（cGVHD）表现多样，但其发病机制尚不清楚。硬化型慢性移植物抗宿主病定位于皮肤损伤部位（同形反应和同位素反应），这在硬斑病中是一种公认的现象，提示cGVHD与其他硬化性皮肤病之间可能存在共同途径。
4例硬化型cGVHD发生于不同的皮肤损伤部位（电离辐射、反复针刺、中心静脉导管置入部位及水痘-带状疱疹病毒感染）。我们回顾了先前报道的与皮肤外力相关的硬化型和非硬化型cGVHD病例谱。
硬化型cGVHD可发生于多种类型的皮肤损伤后，包括紫外线和电离辐射、针刺、病毒感染以及压力或摩擦。认识这一现象可能有助于硬化性疾病的早期诊断。近期对轻微皮肤损伤免疫后果的深入了解可能为cGVHD介导的皮肤病潜在发病机制提供重要线索。
