Graft-versus-host Disease-associated Angiomatosis Treated With Topical Timolol Solution

Scleroderma-like graft-versus-host disease (GVHD) is an uncommon subtype of chronic GVHD. Vascular lesions rarely arise within areas of scleroderma-like changes and until recent- ly have not been considered to be related entities. Kaffenberg et al1 have grouped this heterogeneous collection of vascular lesions under the term GVHD-associated angiomatosis. Treatment modalities thus far have been mostly ineffective. Topical timolol solution has been used in the treatment of superficial infantile hemangiomas with good success. Here the authors report the first case of GVHD-associated angiomatosis treated with topical timolol solution.

Timolol 0.5% solution was applied daily to 3 lesions on the lower extremities of their patient for 3 months.

All lesions decreased in friability and frequency of spontaneous hemorrhage. Le- sions remained stable in size throughout treatment duration, with no growth observed in any lesion. Granulation tissue surrounding all lesions was markedly reduced after the treatment period.

Topical timolol remains a promising therapeutic option in the treat- ment of GVHD-associated angiomatosis.