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Dyskeratosis Congenita or Chronic Graft‐versus‐Host Disease? A Diagnostic Dilemma in a Child Eight Years After Bone Marrow Transplantation for Aplastic Anemia
Author(s) -
Ivker Rachel A.,
Woosley John,
Resnick Steven D.
Publication year - 1993
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/j.1525-1470.1993.tb00400.x
Subject(s) - dyskeratosis congenita , medicine , aplastic anemia , anemia , graft versus host disease , transplantation , biopsy , dermatology , bone marrow , pathology , surgery , dna , genetics , telomere , biology
A 12‐year‐old boy had striking reticulate hyper pigmentation of the neck and upper chest, dystrophic nails, patchy alopecia, and a white streak on the buccai mucosa. He was diagnosed as having chronic graft‐versus‐host disease (GVHD) based on clinical findings, skin biopsy findings, and his history of a bone marrow transplantation for apiastic anemia eight years earlier. Dyskeratosis congenita (DC) was not a diagnostic consideration, although the clinical findings and history of aplastic anemia made it a compelling possibility. This case highlights the clinical similarities between DC and chronic GVHD and the difficulty in arriving at an unequivocal diagnosis.