Vernali Steven, Vertes George Eva, Gonzalez Santiago Tania, Motaparthi Kiran
Department of Dermatology, Boston University School of Medicine, Boston, MA.
Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.
Am J Dermatopathol. 2018 Jul;40(7):511-514. doi: 10.1097/DAD.0000000000001078.
Graft-versus-host disease (GVHD) is the primary cause of morbidity and non-relapse-related mortality after hematopoietic stem cell transplantation. GVHD is classically divided into acute and chronic forms; acute cutaneous GVHD presents as a morbilliform eruption, whereas chronic cutaneous GVHD presents with lichen planus-like or sclerodermoid morphology. Psoriasiform GVHD is a rarely described subtype that is challenging to distinguish clinically from psoriasis. In addition to classic psoriasiform histologic findings, demonstration of an often subtle vacuolar interface dermatitis and lymphocyte satellitosis are helpful for discrimination. Herein, the authors describe psoriasiform GVHD and review the clinicopathologic findings of this unusual variant. With the appropriate clinical findings, psoriasiform GVHD should be considered in the histologic differential diagnosis of a mixed tissue reaction pattern with both psoriasiform and interface changes.
移植物抗宿主病（GVHD）是造血干细胞移植后发病及非复发相关死亡的主要原因。GVHD 传统上分为急性和慢性两种形式；急性皮肤型 GVHD 表现为麻疹样皮疹，而慢性皮肤型 GVHD 表现为扁平苔藓样或硬皮病样形态。银屑病样 GVHD 是一种很少被描述的亚型，在临床上很难与银屑病区分开来。除了典型的银屑病样组织学表现外，常存在的细微空泡界面性皮炎和淋巴细胞卫星现象有助于鉴别。在此，作者描述了银屑病样 GVHD，并回顾了这种不寻常变体的临床病理表现。有相应的临床发现时，在组织学鉴别诊断出现银屑病样和界面改变的混合组织反应模式时，应考虑银屑病样 GVHD。
