Eruptive lesions in a patient with bone marrow transplantation

A 41‐year‐old man with a diagnosis of chronic myeloid leukemia presented with several elevated, small, soft, yellow papules, disseminated over the face and upper trunk. The cutaneous lesions had developed 5 years after transplantation ( Fig. 1). 1Sebaceous hyperplasia on the upper trunk presenting as yellowish, dome‐shaped, asymptomatic papules, 1–2 mm in diameter. The lesion is umbilicated, with individual lobules growing out from the center; lesions may occur individually or in groups In December 1991, he was examined in Israel, where an allogenic bone marrow transplantation was performed, after immunosuppressive treatment with high doses of chemotherapy and lymphoid and total body irradiation. In spite of being on cyclosporine as a preventive medication, at a dose of 3 mg/kg body weight per day, he had a graft‐vs.‐host reaction. Later, he presented with diverse clinical complications: hemorrhagic cystitis; disseminated herpes zoster, with encephalic commitment; pneumonia and sepsis; and chronic graft‐vs.‐host reaction whose manifestations were controlled with decreasing doses of cyclosporine and prednisone. A skin biopsy specimen was obtained, with the diagnosis of sebaceous hyperplasia ( Fig. 2). The histopathologic findings consisted of several enlarged sebaceous glands containing several small ducts, with sebaceous lobules grouped around each of them. The sebaceous gland lobules appeared fully mature, with a single peripheral row of generative cells in which there were few or no lipid droplets. Some of the sebaceous lobules were closed up to the lower portion of the epidermis, from where they extended downwards into the dermis. 2The sebaceous gland lobules appear fully mature, with a single peripheral row of generative cells in which there are few or no lipid droplets