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Dermatologic Treatment of Cutaneous Graft Versus Host Disease

  • Therapy in Practice
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Cutaneous involvement in graft versus host disease (GVHD) after allogeneic hematopoietic cell transplant can be separated into acute GVHD (aGVHD), lichenoid chronic GVHD (cGVHD) and sclerodermatous cGVHD. It seems clear that these syndromes result from different mechanisms and entail different treatment approaches. Standard treatment of cutaneous aGVHD involves the intensification of immunosuppressive therapy with adequate topical supportive management. In skin-limited disease, phototherapy has shown promising results. In cutaneous cGVHD, the combination of corticosteroids and cyclosporine (ciclosporin) is the recommended therapy, and other immunosuppressants may be added depending on whether lichenoid or sclerodermatous lesions are present. High response rates to phototherapy have been found in lichenoid disease, while sclerodermatous disease responds better to etretinate or extracorporeal photochemotherapy. Localized cutaneous cGVHD may be treated with topical corticosteroids alone. Few reports on the effect of treatments in GVHD clearly describe the cutaneous involvement and the influence of the treatment on the skin. Therefore, dermatologists should be deeply involved in the diagnosis and treatment of GVHD, and good dermatologic grading systems should be developed. Theses changes will increase our knowledge of cutaneous GVHD, and relevant data in the evaluation of the effect of therapy in the disease will be obtained.

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No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Dermatology, Hospital Universitario de la Princesa, Diego de Leon 62, Madrid, 28006, Spain

    Pablo F. Peñas, Jesús Fernández-Herrera & Amaro García-Diez

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  1. Pablo F. Peñas
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  2. Jesús Fernández-Herrera
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  3. Amaro García-Diez
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Correspondence to Pablo F. Peñas.

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Peñas, P.F., Fernández-Herrera, J. & García-Diez, A. Dermatologic Treatment of Cutaneous Graft Versus Host Disease. Am J Clin Dermatol 5, 403–416 (2004). https://doi.org/10.2165/00128071-200405060-00005

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