Dermatology Program, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Dermatology Program, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.
J Am Acad Dermatol. 2018 Aug;79(2):230-237. doi: 10.1016/j.jaad.2018.03.029. Epub 2018 Mar 26.
There are limited pediatric data on nonmalignant cutaneous changes, including autoimmune conditions and permanent alopecia, after hematopoietic stem cell transplantation (HSCT).
We sought to characterize late cutaneous changes and associated risk factors after allogeneic HSCT in children.
A cross-sectional cohort study of pediatric HSCT recipients was performed at a single institution. All participants underwent a full skin examination.
The median visit age was 13.8 years, with a median time post-HSCT of 3.6 years. Of 85 patients, 14% (n = 12) had vitiligo, 16% (n = 14) had psoriasis/sebopsoriasis, 25% (n = 21) had alopecia, and 6% (n = 5) had nail changes. Factors significantly associated with vitiligo included a history of chronic graft-versus-host disease (cGVHD), transplant indication of primary immunodeficiency, and younger age at transplant (<10 years of age). Fifty-two percent of patients with alopecia had androgenetic alopecia patterns. Factors significantly associated with alopecia included cGVHD, busulfan conditioning, and family history of early male pattern alopecia. All patients with nail changes had cGVHD.
The cross-sectional design did not allow time of onset identification. Histopathologic correlation was not performed.
Pediatric HSCT recipients, particularly those with cGVHD, are at risk for developing nonmalignant late cutaneous changes.
造血干细胞移植（HSCT）后，儿童非恶性皮肤变化（包括自身免疫性疾病和永久性脱发）的相关儿科数据有限。
我们旨在描述儿童异基因 HSCT 后晚期皮肤变化及相关危险因素。
在一家机构对儿科 HSCT 受者进行了一项横断面队列研究。所有参与者均接受了全面的皮肤检查。
中位就诊年龄为 13.8 岁，中位 HSCT 后时间为 3.6 年。在 85 例患者中，14%（n=12）患有白癜风，16%（n=14）患有银屑病/皮脂溢性银屑病，25%（n=21）患有脱发，6%（n=5）患有指甲变化。白癜风与慢性移植物抗宿主病（cGVHD）病史、原发性免疫缺陷的移植适应证和移植时年龄较小（<10 岁）显著相关。脱发患者中有 52%的人出现雄激素性脱发模式。脱发与 cGVHD、白消安预处理和男性早发性脱发家族史显著相关。所有指甲变化患者均有 cGVHD。
横断面设计无法确定发病时间。未进行组织病理学相关性分析。
儿科 HSCT 受者，尤其是患有 cGVHD 的患者，有发生非恶性晚期皮肤变化的风险。
