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Case 519 - Discussion

Uploaded: 2011-08-21, Updated: 2011-08-21

 

Graft-versus-host disease

  • Morphology:
    • Sparse superficial perivascular lymphocytic infiltrate
    • Basal vacuolar change, dyskeratotic keratinocytes
    • Keratinocyte apoptosis with satellitosis
    • No eosinophils
  • GVHD grading:
    1. Vacuolar alteration of basal and suprabasal cells
    2. Vacuolation, individual apoptosis, epidermotropic lymphocytes
    3. Focal dermo-epidermal separation and cleft formation
    4. Extensive necrosis of epidermis with denudation, and complete separation of the epidermis from the dermis
  • Differential diagnosis: Erythema multiforme - history and bullous formation involving hair follices.
  • List of Interface Dermatitis with Basal Vacuolation

    • Erythema multiforme
    • Graft-versus-host disease
    • Lupus erythematosus
    • Lichen sclerosus
    • Lichenoid keratosis
    • Lichen planus
    • Lichen nitidus
    • Lymphatoid papulosis
    • Mycosis fungoides
    • Dermatomyositis
    • Interface dermatitis of HIV infection
    • Bloom’s syndrome