Related Experiment Videos
[Eczema-like cutaneous graft versus host disease treated by UV-B therapy in a 2-year-old child]
S Tanasescu1, X Balguerie, E Thomine
1Clinique Dermatologique, CHU de Rouen.
Insights
Chronic graft-versus-host disease (GVHD) is rare in children. Broad band UV-B therapy effectively treated a two-year-old boy's eczema-like skin GVHD, allowing medication withdrawal.
Area of Science:
- Pediatric Hematology/Oncology
- Dermatology
- Immunology
Background:
- Chronic graft-versus-host disease (GVHD) is uncommon in pediatric populations.
- Treatment aims to minimize infection and support growth.
- Cutaneous GVHD presents challenges in pediatric patients.
Observation:
- A two-year-old boy developed an eczema-like rash and alopecia three months post-unrelated bone marrow transplant.
- Initial treatment with oral corticosteroids and cyclosporine was insufficient.
- Histopathology confirmed GVHD.
Findings:
- Topical corticosteroids and broad band UV-B therapy were initiated.
- GVHD lesions resolved, enabling gradual withdrawal of systemic immunosuppressants.
- Sustained remission was observed 24 months after systemic treatment cessation.
Implications:
- Broad band UV-B therapy shows promise as an effective treatment for pediatric cutaneous GVHD.
- This approach may offer a way to manage GVHD while reducing immunosuppression.
- Further research into UV-B therapy for pediatric GVHD is warranted.
Introduction:
Chronic graft versus host disease (GVHD) has rarely been reported in children. Optimal treatment should minimize infectious complications and preserve the child's growth. We report a case of cutaneous GVHD in a two year-old boy, who presented an eczema-like eruption and responded well to broad band UV-B therapy.
Case Report:
A two year-old boy with acute myeloblastic leukemia had a heterologous bone marrow transplantation with a graft issued from an unrelated female donor. Three month later, he developed eczema-like lesions of the trunk, arms and legs associated with diffuse alopecia, despite oral corticosteroids and cyclosporine treatment. Histologic findings were consistent with GVHD. Topical corticosteroids and broad band UV-B therapy were initiated, while oral corticosteroids and cyclosporine doses were tappered off. GVHD lesions cleared, allowing withdrawal of oral corticosteroids and cyclosporine 3 and 12 months respectively after initiation of UV-B therapy. No relapse occurred 24 months after systemic treatment discontinuation and 12 months after broad band UV-B therapy was stopped.
Conclusion:
This observation suggests that broad band UV-B therapy is an effective treatment for eczema-like, cutaneous GVHD.