Ann Dermatol.  2009 Aug;21(3):319-322. 10.5021/ad.2009.21.3.319.

A Case of Chronic Cutaneous Graft Versus Host Disease with the Clinical Features of Exfoliative Dermatitis

  • 1Department of Dermatology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.


Graft versus host disease (GVHD) has traditionally been divided into acute GVHD and chronic GVHD based on the period it occurs after transplantation. Chronic cutaneous GVHD has traditionally been classified into the lichenoid and scleroderma-like forms. However, unusual clinical forms have been reported such as dermatomyositis, lupus erythematosus and exfoliative dermatitis. A 35-year-old woman presented with a 2 week history of a pruritic maculopapular rash on the whole body. The rash rapidly progressed to confluent erythematous scaly patches and plaques with micaceous scales and this finally led to a generalized exfoliative dermatitis in a 1 month period. Here we present an unusual case of chronic cutaneous GVHD with the clinical features of exfoliative dermatitis. The histopathologic examination demonstrated the lichenoid features of chronic cutaneous GVHD.


Chronic graft versus host disease; Exfoliative dermatitis

MeSH Terms

Dermatitis, Exfoliative
Graft vs Host Disease
Weights and Measures


  • Fig. 1 Disseminated maculopapular exanthema on the upper extremities.

  • Fig. 2 The histological findings of the lesion showed basal vacuolization, necrotic epidermal cells and lymphocytes in the dermis, and this was all consistent with the diagnosis of acute cutaneous GVHD, grade II (H&E, A: ×100, B: ×200).

  • Fig. 3 Widespread, pruritic confluent erythematous scaly patches and plaques with micaceous scales on the extremities.

  • Fig. 4 The histological finding of the lesion showed hypergranulosis, acanthosis, necrotic keratinocytes, vacuolar alteration of the basal layer and perivascular inflammatory cell infiltration with a faint band-like pattern (H&E, A: ×40, B: ×100).

Cited by  1 articles

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Sihyeok Jang, In Su Kim, Sang Woong Youn
Ann Dermatol. 2016;28(1):90-93.    doi: 10.5021/ad.2016.28.1.90.


1. Andrews ML, Robertson I, Weedon D. Cutaneous manifestations of chronic graft-versus-host disease. Australas J Dermatol. 1997. 38:53–62.
2. Johnson ML, Farmer ER. Graft-versus-host reactions in dermatology. J Am Acad Dermatol. 1998. 38:369–392.
3. Hood AF, Soter NA, Rappeport J, Gigli I. Graft-versus-host reaction. Cutaneous manifestations following bone marrow transplantation. Arch Dermatol. 1977. 113:1087–1091.
4. Ollivier I, Wolkenstein P, Gherardi R, Wechsler J, Kuentz M, Cosnes A, et al. Dermatomyositis-like graft-versus-host disease. Br J Dermatol. 1998. 138:558–559.
5. Girardi M, Herreid P, Tigelaar RE. Specific suppression of lupus-like graft-versus-host disease using extracorporeal photochemical attenuation of effector lymphocytes. J Invest Dermatol. 1995. 104:177–182.
6. Creamer D, Martyn-Simmons CL, Osborne G, Kenyon M, Salisbury JR, Devereux S, et al. Eczematoid graft-vs-host disease: a novel form of chronic cutaneous graft-vs-host disease and its response to psoralen UV-A therapy. Arch Dermatol. 2007. 143:1157–1162.
7. Sehgal VN, Srivastava G, Sardana K. Erythroderma/ exfoliative dermatitis: a synopsis. Int J Dermatol. 2004. 43:39–47.
8. Jih MH, Kimyai-Asadi A, Freedberg IM. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Exfoliative dermatitis. Fitzpatrick's dermatology in general medicine. 2008. 7th ed. New York: McGraw-Hill;225–232.
9. Rym BM, Mourad M, Bechir Z, Dalenda E, Faika C, Iadh AM, et al. Erythroderma in adults: a report of 80 cases. Int J Dermatol. 2005. 44:731–735.
10. Hymes SR, Turner ML, Champlin RE, Couriel DR. Cutaneous manifestations of chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2006. 12:1101–1113.
11. Cook-Norris RH, Weenig RH. Eczematoid graft-vs-host disease. Arch Dermatol. 2008. 144:1066. author reply 1066-1067.
12. Mielcarek M, Martin PJ, Leisenring W, Flowers ME, Maloney DG, Sandmaier BM, et al. Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation. Blood. 2003. 102:756–762.
13. Aractingi S, Chosidow O. Cutaneous graft-versus-host disease. Arch Dermatol. 1998. 134:602–612.
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