Acute Graft versus Host Disease of the Skin
Definition
- Attack by engrafted hematopoietic cells and their progeny on host cutaneous tissues resulting in changes ranging from apoptosis to epithelial denudation
Alternate/Historical Names
- Cutaneous GVHD
Diagnostic Criteria
- Lymphocytic infiltrate and vacuolar alteration at the dermo-epidermal junction
- Individual keratinocyte apoptosis
- Satellitosis (lymphocytes in close proximity to apoptotic keratinocytes)
- Apoptotic keratinocytes in hair follicles in 50-100% of cases
- Basal cell vacuolization (grade I) is nonspecific
- May be caused by pre-transplant chemoradiation or drugs
- Higher grades exhibit dermo-epidermal separation and epithelial separation, see Grading
- Biopsies should be taken 24-48 hours after onset of rash to avoid false negative results seen in earlier biopsies
Sabine Kohler MD
Neeraja Kambham MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : June 30, 2007
