Premium
German–Austrian–Swiss Consensus Conference on clinical practice in chronic graft‐versus‐host disease (GVHD): guidance for supportive therapy of chronic cutaneous and musculoskeletal GVHD
Author(s) -
Marks C.,
Stadler M.,
Häusermann P.,
Wolff D.,
Buchholz S.,
Stary G.,
Lee S.,
Lawitschka A.,
Bertz H.
Publication year - 2011
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2011.10360.x
Subject(s) - medicine , graft versus host disease , german , chronic disease , consensus conference , disease , intensive care medicine , immunology , physical therapy , archaeology , history
Summary Supportive therapy plays a central role in the management of cutaneous and musculoskeletal manifestations of chronic graft‐versus‐host disease (cGVHD), either alone or in combination with systemic approaches. We present results from the German–Austrian–Swiss Consensus Conference on clinical practice in cGVHD, held in Regensburg, Germany, in November 2009. The intention was to achieve a consensus on current evidence‐based treatment options as well as to provide guidelines for daily clinical practice. Skin is the most common organ involved in cGVHD. Its clinical presentation varies considerably. Patients may have pruritus, rash, pain, dyspigmentation and fibrotic or sclerodermatous lesions, often leading to contractures. Treatment options for supportive therapy in cutaneous cGVHD include topical therapies such as topical steroids and topical calcineurin inhibitors, as well as phototherapy and physiotherapy. The most relevant manifestation in musculoskeletal cGVHD is fasciitis which must be distinguished from sclerodermatous skin cGVHD. Physiotherapy is the mainstay of supportive treatment in fasciitis in cGVHD. Successful therapy of cutaneous and musculoskeletal cGVHD depends on interdisciplinary management to improve patients’ quality of life.