Pruritic rash following haploidentical stem cell transplantation

Area of Science:

• Hematology
• Dermatology
• Oncology

Background:

• Hematopoietic stem cell transplantation (HSCT) is a curative therapy for various hematologic malignancies and other diseases.
• Graft-versus-host disease (GVHD) is a common and potentially serious complication following allogeneic HSCT.
• Cutaneous manifestations are frequent in GVHD, but atypical presentations can occur.

Purpose of the Study:

• To describe a unique case of cutaneous GVHD with an unusual histopathological and immunohistochemical profile.
• To highlight the importance of considering differential diagnoses in post-HSCT patients with skin lesions.

Main Methods:

• Clinical presentation and dermatological examination of the patient.
• Histopathological analysis of skin biopsy specimens.
• Immunohistochemical staining for specific cell markers.

Main Results:

• The patient presented with skin lesions suggestive of GVHD.
• Histopathology revealed a diffuse dermal infiltrate of atypical monomorphic cells.
• Immunohistochemistry showed positivity for monocytic markers and negativity for T-cell markers.

Conclusions:

• This case underscores the diverse clinical and pathological spectrum of GVHD.
• The findings suggest a possible monocytic origin of the atypical cells, distinct from typical T-cell mediated GVHD.
• Further investigation into the pathogenesis of such atypical presentations is warranted.