LB1010 Cutaneous manifestations post stem cell transplant

Allogenic stem cell transplant (SCT) and bone marrow (BMT) are curative of conditions including Leukemias, Sickle disease, Thalassemia. Cutaneous manifestations in a post-transplant patient may be an early sign acute graft versus host disease (aGvHD), serious potentially life-threatening reaction to the transplant. Other causes can include medications, reactivation latent viral infections, owing their immune-compromised state1. We present case 28-year-old female with history sickle status post allogenic SCT day 62, HHV-6 infection on 24, who presented pruritic rash that started back her right shoulder two weeks prior, then spread other parts body. Initially, as scattered papules along dermatomes few scalp. She was prescribed acyclovir, however discontinued following infectious specialist ruling out varicella infection. later referred dermatologist noted several dozen erythematous violaceous plaques collarette scale ranging from mm > 1 cm symmetrically distributed Langer's lines involving mainly upper chest, back, arms, neck, lateral cheeks, scalp, medial thighs. Biopsy lesion revealed vesicular spongiotic dermatitis eosinophils consistent Pityriasis Rosea. aGvHD is BMT, typically involves skin manifestations. There have been studies demonstrating atypical clinical presentations aGvHD1, 2 those appear exanthems. Early biopsies become diagnostic therefore necessary rule aGVHD tailor treatment plans accordingly. 1. Aractingi, S. O. Chosidow, graft-versus-host disease. Arch Dermatol, 1998. 134(5): p. 602-12. 2. Cornejo, C.M., et al., Atypical J Am Acad 2015. 72(4): 690-5.