Iatrogenic cutaneous graft versus host disease

Abstract

A 65-year-old man with acute myeloid leukemia was treated by bone marrow allograft and developed classic systemic chronic graft versus host disease with hepatic, rheumatologic, ophthalmic, and mucocutaneous involvement. He received systemic corticosteroid, ruxolitinib, and extracorporeal photopheresis, which resulted in complete remission. During follow-up the patient presented with viral cutaneous warts on his neck and submandibular area. After various subsequent topical treatments, he developed localized cutaneous GVHD without any general GVHD reactivation symptoms. To the best of our knowledge, there has been no description in the literature of graft versus host disease developing after local immunomodulatory or cytotoxic treatments. Topical immune-stimulating therapies are commonly used by dermatologists for superficial skin cancers and some viral skin lesions in high-risk populations such as organ transplant patients. Practitioners should be made aware of a possible localized cutaneous GVHD reactivation induced after local therapy.