Atopic dermatitis-like presentation of graft-versus-host disease: A novel form of chronic cutaneous graft-versus-host disease

Background: Graft-versus-host disease (GVHD) is a systemic disease, and skin is often one of the target organs. An atopic dermatitis (AD)-like presentation has never to our knowledge been reported. Objective: We sought to describe an AD-like presentation of cutaneous GVHD. Methods: Data on 11 patients with an AD-like presentation of GVHD were collected. The clinical and laboratory findings were retrospectively studied. Results: All 11 patients developed skin lesions after hematopoietic stem-cell transplantation. The skin lesions occurred between 2 to 12 months after transplantation. Eight patients received their transplant from a first-degree family member; 3 received their transplant from an unrelated donor. The skin lesions were pruritic and suggestive of AD, whereas the histology showed features of AD and GVHD. The lesions responded to topical and systemic anti-inflammatory and immunosuppressive therapy and phototherapy. Limitations: The number of patients is small and the study is retrospective. Conclusions: AD-like GVHD might represent a novel form of chronic cutaneous GVHD and responds well to treatment.