Severe Desquamating Disorder After Liver Transplant

OBJECTIVE The objective of this article is to present and discuss the clinical characteristics of TEN (Toxic Epidermal Necrolysis) and GVHD (Graft Versus Host Disease) following orthotopic liver transplantation. METHODS Recent experience with a patient who suffered a fatal desquamation syndrome within weeks of liver transplantation provides the basis for a discussion of differential diagnosis of these two conditions. RESULTS TEN and GVHD demonstrate similar clinical presentations as well as etiology (CD8+ lymphocyte attack on epithelial surfaces). This case demonstrates the difficulty in distinguishing between these two conditions in this particular patient. CONCLUSIONS Advances in the understanding and treatment of one of these disease states may provide therapeutic insights into the other.