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Chronic cutaneous graft‐versus‐host disease in children: A report of 14 patients from a tertiary care pediatric dermatology clinic
Author(s) -
Nanda Arti,
Husain Maitham A. A.,
AlHerz Waleed,
Almekaimi Adla,
AlSabah Humoud,
AlOtaibi Mohammad
Publication year - 2018
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/pde.13432
Subject(s) - medicine , graft versus host disease , poikiloderma , hematopoietic stem cell transplantation , complication , disease , overlap syndrome , dermatology , surgery
Abstract Background/Objectives Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment option for many life‐threatening disorders in children. Chronic graft‐versus‐host disease (cGVHD) is a significant complication of HSCT, and its treatment is challenging. Skin is the most common organ affected in cGVHD, with protean manifestations posing a challenge in diagnosis and management. The objective was to have a better understanding of the spectrum of chronic cutaneous GVHD (cc‐GVHD) in children. Methods Hospital records of 14 children with cc‐GVHD, registered over 9 years, were reviewed. Results All the patients had received HSCT from related donors. Median duration between HSCT and onset of cc‐GVHD was 7.5 months. Eighty‐six percent of the patients had a prior history of aGVHD, and 14% had de novo onset of cc‐GVHD. Of 14 patients, 71% had classic cc‐GVHD. Overlap syndrome was observed in 29%. Tandem occurrence of multiple morphologies was noticed in 6 (43%) patients. Of classic cc‐GVHD, lichen planus‐like cc‐GVHD was most common (57%) followed by scleroderma‐like (29%) and poikiloderma (7%). Rare variants included eczema‐like (14%) and psoriasis‐like (7%) cc‐GVHD. Mucosal involvement was seen in 78.6% of the patients, nail involvement in 50%, and hair abnormalities in 43%. After a median follow‐up of 4.8 years, complete remission was observed in 50% and mortality in 14%. Conclusion The study signifies the diverse nature of cc‐GVHD and indicates the need for multicenter surveys including larger number of patients to have proper insight into and develop treatment guidelines for cc‐GVHD in children.