549 Clinical features and risk factors of cutaneous eruptions after stem cell transplantation

Patients who receive stem cell transplantation (SCT) can develop cutaneous eruptions with systemic involvement such as graft versus host disease (GVHD), drug hypersensitivity syndrome (DIHS), or viral exanthema. These conditions often have overlapping clinical and laboratory presentations may be associated risk factors reactivation medications. In this study, we evaluated the incidence, presentation, of skin in 1,458 patients received SCT between 9/1/2018 to 8/1/2020. Clinical titers, medication history were obtained by chart review. A eruption occurred 962 (66%) at a median 1.8 months post-SCT. 535 (56%) diagnosed GVHD, 140 (15%) had reaction, 19 (2%) exanthem. 121 (13%) other diagnoses (eg, psoriasis), while 159 (17%) did not specific diagnosis. 562 (37%) detectable load, which was (72% vs. 51%; p<0.01). 128 (9%) EBV viremia, 415 (28%) CMV 172 (11%) HHV-6 viremia. Viral loads became first for HHV6 (median 27 days), followed 34 days) 104 days). Overall, GVHD more likely than present pruritus (60% 43%; p<0.001) head/neck (68% 49%; p<0.001), trunk (79% 57.1%; upper extremities (58% 44%; p<0.001). Viremia (50% 38%; prophylaxis sirolimus (39% 30%; p=0.03), tacrolimus (82% 52%; mycophenolate mofetil (98% 71%; also common GVHD. There no differences features lower palms/soles infection valacyclovir trimethoprim-sulfamethoxazole. We are currently investigating combinations markers help differentiate DIHS, exanthema post-SCT patients.