Vitiligo type cutaneous manifestation of chronic graft-versus-host disease. Case report
Author
dc.contributor.author
Gálvez, Karla
Author
dc.contributor.author
Muñoz, Paula
Author
dc.contributor.author
Vera, Valentina
Author
dc.contributor.author
Arce, Claudio
Admission date
dc.date.accessioned
2018-08-16T19:44:57Z
Available date
dc.date.available
2018-08-16T19:44:57Z
Publication date
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2018
Cita de ítem
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Rev Chil Pediatr. 2018;89(1):113-117
es_ES
Identifier
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0717-6228
Identifier
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10.4067/S0370-41062018000100113
Identifier
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https://repositorio.uchile.cl/handle/2250/151043
Abstract
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Introduction: Graft-versus-host disease (GVHD) is caused by a pathologic and destructive response of the organism as a result of the interaction between donor immunocompetent T lymphocytes and the recipient tisular antigens. It's considered the most serious complication of hematopoietic stem cell transplantation, most frequently described after bone marrow transplantation (BMT). The skin is usually the first and most commonly affected organ, in both acute and chronic, with a variable clinical spectrum of presentation. Objective: To report a case of vitiligo as a manifestation of cutaneous chronic GVHD, a low prevalence sign, which recognition could help to suspect this severe complication. Case report: 8 years old male, diagnosed with acute lymphoblastic leukemia (ALL) at 3 years old, had a combined medullary and central nervous system (NCS) relapse with minimal positive disease 3 years afterwards. After 4 years ALL was diagnosed, he received an allogeneic bone marrow transplant. Seven months after the BMT he presented multiple melanocytic nevi with peripheral hypopigmentation, and some isolated asymptomatic, confluent achromic macules on the face, trunk and limbs. The skin biopsy was compatible with chronic vitiligo and sclerodermiform type GVHD. He received topical treatment with Tacrolimus, achieving clinical stabilization. Conclusions: GVHD leads to the appearance of autoantibodies that could act as a trigger in the onset of autoimmune diseases, such as vitiligo. Consequently it could explain this poorly described manifestation in the literature of chronic cutaneous GVHD.