Centro de Transplante de Medula Óssea-CEMO, Instituto Nacional de Câncer José Alencar Gomes da Silva-INCA, Rio de Janeiro, Brazil.
Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.
Am J Clin Dermatol. 2018 Feb;19(1):33-50. doi: 10.1007/s40257-017-0306-9.
Graft-versus-host disease (GVHD) is an immunological reaction and a frequent complication following allogeneic hematopoietic stem cell transplantation. It is associated with high mortality rates and may have a significant negative impact on the patient's quality of life, particularly in the chronic-stage setting. Many different organs can be involved, which leads to a wide range of clinical manifestations. In this context, dermatologists play a key role by diagnosing and treating GVHD from the outset since cutaneous features are not just the most common but are also usually the presenting sign. Several skin-direct therapies are available and may be indicated as monotherapy or adjuvant treatment in order to allow faster tapering and withdrawal of systemic immunosuppression. Treatment of steroid-refractory patients remains a challenge and, to date, no consensus has been reached for one single agent in second-line therapy. This article aims to review skin involvement as well as provide and update discussion on therapeutic options for both acute and chronic cutaneous GVHD.
移植物抗宿主病（GVHD）是一种免疫反应，是异基因造血干细胞移植后的常见并发症。它与高死亡率相关，可能对患者的生活质量产生重大负面影响，尤其是在慢性期。许多不同的器官都可能受到影响，导致广泛的临床表现。在这种情况下，皮肤科医生通过从一开始就诊断和治疗 GVHD 发挥着关键作用，因为皮肤特征不仅是最常见的，而且通常也是最初的表现。有几种皮肤直接治疗方法可用，可作为单一疗法或辅助治疗，以允许更快地减少和停用全身免疫抑制。类固醇难治性患者的治疗仍然是一个挑战，迄今为止，二线治疗中还没有一种单一药物达成共识。本文旨在回顾皮肤受累情况，并提供和更新讨论急性和慢性皮肤 GVHD 的治疗选择。
