Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Department of Dermatology, Medical University of Vienna, Vienna, Austria -
G Ital Dermatol Venereol. 2020 Feb;155(1):76-87. doi: 10.23736/S0392-0488.19.06535-0.
Graft-versus-host disease (GvHD) is a commonly occurring immunological reaction and frequent complication following allogeneic hematopoietic stem cell transplantation. Its highly diverse manifestations including skin involvement as the most common appearance of GvHD, can dramatically influence patient's quality of life, in particular in the chronic stage, in addition to patient's decreased survival outcome. Hence, the role of the dermatologist has become very crucial in an interdisciplinary setting, particularly since appearances of GvHD in the skin can be multifaceted and challenging. Clinical manifestation of the acute GvHD (aGvHD) is limited to erythematous maculopapular rash and oral mucosal lesions while the chronic form manifests in a wider range in a localized area or disseminated including involvement of nail, scalp and genital area. This article aims to provide a comprehensive overview on the variable cutaneous presentations of acute and chronic GvHD for a proper and early diagnosis on the one hand, and to discuss updated therapeutic options for both acute and chronic GvHD on the other hand, to initiate an adequate treatment to obtain the most beneficial clinical outcome.
移植物抗宿主病(GvHD)是一种常见的免疫反应,也是异基因造血干细胞移植后的常见并发症。它的表现形式多种多样,包括皮肤受累,是 GvHD 最常见的表现形式,除了患者的生存结果降低外,还会显著影响患者的生活质量,尤其是在慢性期。因此,皮肤科医生在跨学科环境中的作用变得非常关键,特别是因为 GvHD 在皮肤中的表现可能是多方面的,具有挑战性。急性 GvHD(aGvHD)的临床表现仅限于红斑性斑丘疹和口腔黏膜病变,而慢性形式则在局部或播散性区域表现出更广泛的范围,包括指甲、头皮和生殖器区域的受累。本文旨在全面概述急性和慢性 GvHD 的各种皮肤表现,以便一方面进行正确和早期诊断,另一方面讨论急性和慢性 GvHD 的最新治疗选择,以启动适当的治疗,获得最有益的临床结果。