Sundram Uma
Departments of *Pathology †Dermatology, Stanford University Medical Center, Stanford, CA.
Adv Anat Pathol. 2014 Sep;21(5):321-9. doi: 10.1097/PAP.0000000000000033.
Hematopoietic stem cell transplantation continues to be the mainstay of treatment for many hematologic dyscrasias and malignancies, including acute leukemias, lymphomas, and aplastic anemia. There can be significant complications, however, and often these complications are manifested in the skin as an eruption. Common among these are acute and chronic graft-versus-host disease, erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis, eruption of lymphocyte recovery, staphylococcal scalded skin syndrome, morbiliform drug eruptions, infections, and toxic erythema of chemotherapy. These entities can show significant clinical and histopathologic overlap, yet accurate distinctions among them are critical to initiating appropriate clinical interventions. In this review, we will discuss the key clinical and histopathologic findings in each entity as well as appropriate differential diagnostic entities.
造血干细胞移植仍然是许多血液系统发育异常和恶性肿瘤(包括急性白血病、淋巴瘤和再生障碍性贫血)治疗的主要手段。然而,可能会出现严重的并发症,而且这些并发症常常在皮肤表现为皮疹。其中常见的有急慢性移植物抗宿主病、多形红斑、史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症、淋巴细胞恢复性皮疹、葡萄球菌性烫伤样皮肤综合征、麻疹样药疹、感染以及化疗所致的中毒性红斑。这些病症可能在临床和组织病理学上有显著重叠,但准确区分它们对于启动适当的临床干预至关重要。在本综述中,我们将讨论每种病症的关键临床和组织病理学表现以及合适的鉴别诊断疾病。