GVHR with clinical features of scleroderma and lichen sclerosus.

Abstract

A17-year-old girl, who 15 months earlier had received an allogeneic bone marrow transplant from her brother due to high-risk acute lymphoblastic leukemia, was first observed. Hardening of the skin had started a year after trans-plantation affecting mainly the chest. Physical examination (Fig. 1) highlighted on inspection the prevailing involvement of the mammary region, where there was a pearly skin, devoid of hair. The margins of the lesions sometimes had subtle ramifications and isolated lesions of 1-2 mm in size. On palpation, the skin appeared thickened and sclerotic. Similar lesions were present in the suprapubic region (inset Figure 1), where micro-papules were more obvious. The final diagnosis was graft-versus-host reaction with aspects of scleroderma and lichen sclerosus.