Abstract：
Skin is commonly affected by graft versus host disease (GVHD), a complication of bone marrow transplantation (BMT). One-third of hematopoietic cell transplantation recipients develop acute eruption classically described as folliculocentric, maculopapular, or morbilliform, in contrast to the more common chronic presentations of sclerotic, poikilodermic, or lichenoid dermatitides. With the wider use of non-myeloablative (reduced-intensity) transplant therapy, various atypical presentations can occur, representing a diagnostic challenge. Herein, we report an unusual case of chronic GVHD manifested by two distinct clinical and histopathological features lacking the classical presentation. Five months after her BMT, the patient presented with a papulosquamous eruption on her neck, trunk, and arms showing a psoriasiform histopathological pattern of chronic GVHD. She also demonstrated multiple small flesh-colored papules on her distal extremities showing a solitary syringotropic pattern of GVHD, demonstrated by interface dermatitis involving the superficial eccrine duct, as the only diagnostic histopathological feature of GVHD. This report, with review of literature, highlights the uncommon psoriasiform GVHD and the novel description of isolated syringotropic chronic GVHD.
摘要：
皮肤通常受移植物抗宿主病（GVHD）的影响，骨髓移植（BMT）的并发症。三分之一的造血细胞移植受者发生急性喷发，通常被描述为卵泡中心，斑丘疹,或者男性，与更常见的硬化慢性表现相反，polikilodermic,或苔藓类皮肤。随着非清髓性（降低强度）移植治疗的广泛使用，可能会出现各种非典型的表现，代表诊断挑战。在这里，我们报告了一例罕见的慢性GVHD病例，表现为两种不同的临床和组织病理学特征，缺乏经典表现。她的BMT后五个月，病人的脖子上出现了丘疹鳞状皮疹，树干,和显示慢性GVHD的银屑病样组织病理学模式的手臂。她还在远端四肢上表现出多个小的肉色丘疹，显示出孤立的促注射器型GVHD，表现为涉及浅表内分泌导管的界面性皮炎，作为GVHD的唯一诊断性组织病理学特征。这份报告,通过文献回顾，突出了罕见的银屑病样GVHD和孤立的促注射器性慢性GVHD的新颖描述。
