2009
DOI: 10.1111/j.1468-3083.2009.03326.x
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Stage IV cutaneous acute graft-versus-host disease. Clinical and histological study of 15 cases

Abstract: Stage IV cutaneous aGVHD is a severe and unusual complication after haematopoietic stem cell transplantation. Prognosis is poor with a very high mortality rate, although the cause of death is varied and not strictly linked to the cutaneous disease.

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Cited by 13 publications
(11 citation statements)
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“…More severe cases will require systemic immunosuppressive treatment 6 . Around 2% of cases 20 develop vesicles, epidermal necrosis with positive Nikoslky sign, and generalized erythroderma, resembling toxic epidermal necrolysis (stage IV disease) 21 …”
Section: Acute Graft‐versus‐host Diseasementioning
confidence: 99%
“…More severe cases will require systemic immunosuppressive treatment 6 . Around 2% of cases 20 develop vesicles, epidermal necrosis with positive Nikoslky sign, and generalized erythroderma, resembling toxic epidermal necrolysis (stage IV disease) 21 …”
Section: Acute Graft‐versus‐host Diseasementioning
confidence: 99%
“…Departments of Dermatology, 1 In our case, bullous-type chronic cutaneous GVHD with subepidermal blister formation should be considered as a differential diagnosis. However, our case showed linear IgG deposits in the BMZ and circulating anti-BMZ antibodies on immunofluorescence studies, although no reactivity with either BP230 or BP180 was detected on ELISAs and immunoblot analyses.…”
Section: Kozo Yoneda 1 Toshio Demitsu 2 Maki Kakurai 2 Tae Narimentioning
confidence: 89%
“…GVHD reveals various skin lesions, such as maculo-papular rash, brownish pigmentation, and scleroderma (1). Although GVHD may present subepidermal blisters caused by vacuolar degeneration of basal cells, the association of bullous pemphigoid (BP) and GVHD is extremely rare (1).…”
mentioning
confidence: 99%
“…It is interesting to note that Grover's disease occurred within the first 2 weeks of bone marrow transplant in Harvell and colleagues and our study. This observation is important as bone marrow engraftment usually occurs between days 10 and 14 after the infusion of stem cells; hence, it is crucial to differentiate Grover's disease occurring at this time from early stage IV skin GVHD or toxic epidermal necrolysis (TEN) . Although they are clinically different, physicians and pathologists might mistakenly misdiagnose Grover's disease as a severe form of GVHD due to the vesicular and crusted clinical appearance together with the acantholytic findings in the histopathology.…”
Section: Discussionmentioning
confidence: 99%
“…The typical histological features of Grover's disease are acantholysis, dyskeratosis and suprabasal clefting. Dyskeratosis is also a prominent feature of chemotherapy‐induced cutaneous toxicity, GVHD and engraftment syndrome, while clefting can be seen in grade III and IV GVHD as well as in TEN . Acantholysis is an unusual finding in any of these differential diagnoses, and only Grover's disease features suprabasal clefting and acantholysis.…”
Section: Discussionmentioning
confidence: 99%