Li Alvin W, Lalor Leah E, Bellodi Schmidt Fernanda, Luu Minnelly
School of Medicine, Yale University, New Haven, CT, USA.
University of California, San Francisco, San Francisco, CA, USA.
Pediatr Dermatol. 2018 May;35(3):e165-e169. doi: 10.1111/pde.13473. Epub 2018 Mar 23.
Sclerodermatous graft-versus-host disease is a subtype of cutaneous chronic graft-versus-host disease that is characterized by sclerosis of the skin and subcutaneous tissue, resulting in debilitating contractures, among other life-threatening complications. Children with sclerodermatous graft-versus-host disease are at high risk of developing nonmelanoma skin cancer because of several risk factors, including young age at transplantation, prolonged immunosuppression, and exposure to photosensitizing antimicrobial prophylaxis such as voriconazole. The immunosuppression required to treat sclerodermatous graft-versus-host disease makes effectively treating nonmelanoma skin cancer and sclerodermatous graft-versus-host disease in the same patient challenging. We describe a challenging case of a 6-year-old boy with a history of sclerodermatous graft-versus-host disease and voriconazole exposure presenting with squamous cell carcinoma in situ on the left temple and actinic keratoses on the scalp treated with topical chemotherapy agents.
硬皮病样移植物抗宿主病是皮肤慢性移植物抗宿主病的一种亚型，其特征为皮肤和皮下组织硬化，导致使人衰弱的挛缩以及其他危及生命的并发症。患有硬皮病样移植物抗宿主病的儿童由于多种风险因素，包括移植时年龄小、长期免疫抑制以及接触如伏立康唑等光敏性抗菌预防药物，发生非黑色素瘤皮肤癌的风险很高。治疗硬皮病样移植物抗宿主病所需的免疫抑制使得在同一患者中有效治疗非黑色素瘤皮肤癌和硬皮病样移植物抗宿主病具有挑战性。我们描述了一例具有挑战性的病例，一名6岁男孩有硬皮病样移植物抗宿主病病史且接触过伏立康唑，其左颞部出现原位鳞状细胞癌，头皮有光化性角化病，采用局部化疗药物进行治疗。
