Chronic graft‐versus‐host disease and inhibition of interleukin‐17: proof of concept in humans

Unusual presentations of chronic graft versus host disease

Skin is commonly affected by graft versus host disease (GVHD), a complication of bone marrow transplantation (BMT). One-third of hematopoietic cell transplantation recipients develop acute eruption classically described as folliculocentric, maculopapular, or morbilliform, in contrast to the more common chronic presentations of sclerotic, poikilodermic, or lichenoid dermatitides. With the wider use of non-myeloablative (reduced-intensity) transplant therapy, various atypical presentations can occur, representing a diagnostic challenge. Herein, we report an unusual case of chronic GVHD manifested by two distinct clinical and histopathological features lacking the classical presentation. Five months after her BMT, the patient presented with a papulosquamous eruption on her neck, trunk, and arms showing a psoriasiform histopathological pattern of chronic GVHD. She also demonstrated multiple small flesh-colored papules on her distal extremities showing a solitary syringotropic pattern of GVHD, demonstrated by interface dermatitis involving the superficial eccrine duct, as the only diagnostic histopathological feature of GVHD. This report, with review of literature, highlights the uncommon psoriasiform GVHD and the novel description of isolated syringotropic chronic GVHD.

Psoriasiform graft-versus-host disease responded to secukinumab: A case report

We describe a 9-year-old boy who developed generalised erythematous lesions 12 months after haematopoietic stem cell transplant (HSCT). Histopathology showed both features of psoriasis and graft-versus-host disease (GVHD). The lesions responded well to secukinumab, suggesting that IL-17A monoclonal antibody might be a treatment option for GVHD.