[Diagnosis of cutaneous graft-versus-host disease: pathomorphological aspects]

To study the differential diagnostic value of histological and immunohistochemical signs in skin biopsy specimens in graft-versus-host disease (GVHD).

Hematoxylin- and eosin-stained skin biopsy specimens from 50 patients with GVHD and 10 patients with toxicoderma were examined; immunohistochemical reactions using antibodies against CD3, CD20, CD4, CD8, FOXP3, CD56, CD1a, and CD68 were performed. The significance of differences between the groups was estimated using the chi2 and Mann-Whitney tests.

In GVHD, there was a significantly high count of necrotic epidermocytes with satellite cells in the epidermis, more commonly apoptosis of epitheliocytes in the skin appendages and vacuolar dystrophy of epidermocytes. On the contrary, the count of eosinophilic granulocytes, CD1a+, CD3+, FOXP3+, and CD8+ cells and the proportion of FOXP3+ cells proved to be significantly higher in the toxicoderma group.

The results of the investigation were used to form groups of signs that were important in the differential diagnosis of cutaneous GVHD and toxic and allergic reactions.