Steroid refractory psoriasiform cutaneous graft versus host disease successfully treated by extracorporeal photopheresis: a case report

Transfus Apher Sci. 2013 Feb;48(1):109-11. doi: 10.1016/j.transci.2012.07.018. Epub 2012 Sep 25.

Abstract

Graft-versus-host disease (GVHD) is a frequent complication occurring after allogeneic hematopoietic stem cell transplantation. It can be classified as acute and chronic GVHD based on the time of onset following transplantation and clinical presentation. Cutaneous involvement is the most common feature of acute GVHD, with maculopapular exanthema and perifollicular papular lesions. Steroid refractory GVHD is associated with a significant morbidity and mortality. We present a very rare case with acute cutaneous GVHD mimicking psoriasis vulgaris occurring after allogeneic peripheral blood stem cell transplantation for chronic lymphocytic leukemia. The patient's rash resembled psoriasis vulgaris and showed histologic features of both psoriasis and acute GVHD. Despite concomitant cyclosporine A and methylprednisolone therapy no response was obtained. Therefore, we administered extracorporeal photopheresis and achieved the desired therapeutic effect.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Graft vs Host Disease / drug therapy
  • Graft vs Host Disease / pathology
  • Graft vs Host Disease / therapy*
  • Humans
  • Male
  • Photopheresis / methods*
  • Psoriasis / drug therapy
  • Psoriasis / pathology
  • Psoriasis / therapy*