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Among the late effects, cutaneous cGVHD (skin and oral mucosal) is the most common organ/system involved by GVHD [21]. It expresses itself in a variety of manifestations from chronic eczematous form [22], to lichen planus‐like lesions [23]. The affected skin can become progressively indurated and fixed to the underlying fascia, resulting in prominent morphea and scleroderma, which can lead to joint contractures [24] and a significant compromise in QOL of HCT patients.

Though skin cGVHD is one of the leading causes of morbidity in HCT recipients, a thorough evaluation for other causes of cutaneous complications pertinent to allogeneic‐HCTs is warranted in symptomatic patients. Invasive mold infections can affect the skin of HCT recipients. Photosensitive rash may represent GVHD or may occur as an adverse effect of certain medications commonly utilized in HCT recipients for treatment or prevention of infections particularly with voriconazole [25]. In some patients, pre‐HCT chemotherapy with busulfan, cyclophosphamide, or hydroxyurea may lead to permanent darkening and/or thickening of the skin, which may masquerade as initial stages of cGVHD. Skin cancers are the most common solid malignancies occurring post‐HCT. Routine surveillance with dermatologic exams at annual intervals is recommended [1,26].