[Dermatopathic lymphadenopathy in chronic skin graft-versus-host disease]

A 46-year-old woman developed chronic skin graft-versus-host disease (GVHD) with bilateral axillary lymph node (LN) swelling 7 months after cord blood transplantation for acute myeloid leukemia. Histological examination of the LNs revealed dermatopathic lymphadenopathy (DL). After treatment with topical steroids, GVHD improved and lymphadenopathy subsided.DL typically occurs associated with chronic dermatologic disorders, and its pathology is characterized by paracortical LN hyperplasia by Langerhans cells and interdigitating cell infiltration. LN swelling rarely occurs with GVHD, and the clinical course in this patient suggests that her DL was caused by chronic skin GVHD. Interestingly, chimerism analysis of the Langerhans cells indicated donor origin.