Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.
Department of Dermatology, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA.
Dermatol Clin. 2019 Oct;37(4):569-582. doi: 10.1016/j.det.2019.05.014. Epub 2019 Jul 10.
Graft-versus-host disease (GVHD) is an adverse immunologic phenomenon following allogenic hematopoietic stem cell transplant. Cutaneous manifestations are the earliest and most common presentation of the disease. This article describes the pathophysiology, clinical presentation, diagnosis, and treatment options available for acute and chronic GVHD. Acute and chronic GVHD result from an initial insult triggering an exaggerated inflammatory cascade. Clinical presentation for cutaneous acute GVHD is limited to maculopapular rash and oral mucosal lesions, whereas chronic GVHD can also include nail, scalp, and genitalia changes. Diagnosis is often made clinically and supported by biopsy, laboratory and radiology findings.
移植物抗宿主病(GVHD)是异基因造血干细胞移植后一种不良的免疫现象。皮肤表现是该病最早和最常见的表现。本文描述了急性和慢性 GVHD 的发病机制、临床表现、诊断和治疗选择。急性和慢性 GVHD 是由初始损伤引发的过度炎症级联反应引起的。皮肤急性 GVHD 的临床表现仅限于斑丘疹和口腔黏膜病变,而慢性 GVHD 还可包括指甲、头皮和生殖器的变化。诊断通常通过临床检查和活检、实验室及影像学检查结果来支持。