[Two cases of postoperative erythroderma--clinical and pathological investigation]

Two cases of postoperative erythroderma, considered the Graft-Versus-Host disease like syndrome following blood transfusion during open heart surgery, were reported. In one, a 74-year-old female underwent the patch closure of ventricular septal perforation complicated with acute myocardial infarction, and in the other, a 67-year-old female underwent coronary artery bypass surgery. They had sudden fever, general eruption, liver dysfunction, leucopenia and thrombocytopenia, and died on the 15th and the 21st days after operation. In both, pathologically, eosinophilic necrosis was seen in agreement with basal cells and prickle cells on the epidermis. T-cells and monocytes widely infiltrated on the upper dermis, particularly around blood vessels. Furthermore, similar to on the skin, cellular infiltration and eosinophilic necrosis were seen on the esophageal mucosa. Various immunoglobulin-positive cells were seen on the dermis and the esophageal mucosa, but it is not clear that this is characteristic or not, because secondary infection possibly existed on them.