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OBSERVATION Localization of Sclerotic-type Chronic Graft-vs-Host Disease to Sites of Skin Injury Potential Insight Into the Mechanism of Isomorphic and Isotopic Responses Kathryn J. Martires, BS; Kristin Baird, MD; Deborah E. Citrin, MD; Fran T. Hakim, PhD; Steven Z. Pavletic, MD; Edward W. Cowen, MD, MHSc Background: The mechanisms responsible for the vari- trum of previously reported cases of sclerotic and non- able manifestations of chronic cutaneous graft-vs-host dis- sclerotic cGVHD relating to external forces on the skin. ease (cGVHD) are poorly understood. Localization of scle- rotic-type chronic graft-vs-host disease to sites of skin Conclusions: Localization of sclerotic-type cGVHD may injury (isomorphic and isotopic responses), a recog- occur after many types of skin injury, including UV and nized phenomenon in morphea, suggests a potential com- ionizing radiotherapy, needle sticks, viral infection, and mon pathway between cGVHD and other sclerotic skin pressure or friction. Recognition of this phenomenon may conditions. be helpful for the early diagnosis of sclerotic disease. Re- cent insights into the immunological consequences of mi- Observations: Four cases of sclerotic-type cGVHD de- nor skin injury may provide important clues to the un- veloped at the site of disparate skin injuries (ionizing ra- derlying pathogenesis of cGVHD-mediated skin
JAMA Dermatology – American Medical Association
Published: Sep 1, 2011
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