Vashisht Deepak, Kothari Rohit, Baveja Sukriti, Neema Shekhar, Sengupta Prashant, Sandhu Sunmeet
Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India.
Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India.
Indian Dermatol Online J. 2020 Sep 19;11(6):988-990. doi: 10.4103/idoj.IDOJ_87_20. eCollection 2020 Nov-Dec.
Graft versus host disease (GVHD) is a unique entity wherein the donated marrow cells (graft) view the hosts as foreign and attack various body organs. Skin is the most frequently affected organ followed by mucosa, eyes, gastrointestinal, respiratory, musculoskeletal system, and other organs. The incidence of GVHD varies from 25 to 80%. Cutaneous involvement can present as exanthem, epidermolysis, lichenoid eruptions, erythroderma, ichthyosis, pityriasis rubra pilaris like lesions, psoriasiform lesions or just pruritus. Asymptomatic truncal follicular eruptions as the major presentation is rare. We report a case of aplastic anemia that developed extensive truncal folliculocentric papules 10 months following an allogeneic hematopoietic stem cell transplantation. Histopathological examination of the follicular lesions revealed perifollicular inflammatory infiltrate comprising of lymphocytes, plasma cells and histiocytes at the dermo-epidermal junction. Basal cell vacuolization, pigment incontinence in the upper dermis and few apoptotic keratinocytes in the follicular epidermis were also seen. The patient responded satisfactorily to tapering doses of steroids.
移植物抗宿主病（GVHD）是一种独特的病症，其中捐赠的骨髓细胞（移植物）将宿主视为异物并攻击身体的各个器官。皮肤是最常受影响的器官，其次是黏膜、眼睛、胃肠道、呼吸系统、肌肉骨骼系统和其他器官。GVHD的发病率在25%至80%之间。皮肤受累可表现为皮疹、表皮松解、苔藓样疹、红皮病、鱼鳞病、毛发红糠疹样病变、银屑病样病变或仅表现为瘙痒。以无症状的躯干毛囊疹为主要表现较为罕见。我们报告一例再生障碍性贫血患者，在异基因造血干细胞移植10个月后出现广泛的躯干毛囊中心性丘疹。毛囊病变的组织病理学检查显示在真皮表皮交界处有由淋巴细胞、浆细胞和组织细胞组成的毛囊周围炎性浸润。还可见基底细胞空泡化、真皮上层色素失禁以及毛囊表皮中少数凋亡的角质形成细胞。患者对逐渐减量的类固醇治疗反应良好。
