Chronic graft-versus-host disease with follicular involvement

The clinical and histopathological findings in a 25-year-old Japanese male patient who suffered from chronic graft-versus-host-disease (GVHD) with follicular involvement are described. The patient had been diagnosed as aplastic anemia and underwent an allogeneic bone marrow transplant (BMT). In the eighth month thereafter, pruritic follicular red papules developed over his trunk and extremities. A biopsy specimen revealed histological exocytosis of lymphocytes into the hair follicles and basal-cell vacuolization of the follicular epithelium. Analysis of T-lymphocyte subpopulations in the dermis revealed a predominance of CD4 positive cells. To our knowledge, several cases of acute follicular GVHD have been reported; however, the occurrence of chronic GVHD with follicular involvement (chronic follicular GVHD) has not been clearly documented.