Abstract
A case of graft-versus-host disease following bone marrow transplantation was reported. The bone marrow transplantation from an HLA-matched brother was carried out on a 23-year-old Japanese man who was suffering from continuous infectious episodes because of dysfunction and immaturity of neutrophils. 12 days after transplantation, he noticed a widespread maculopapular rash on his shoulders and back. Histologically, intercellular edema, fissures and dyskeratotic cells in the squamous cell layer, liquefaction degeneration of basal cell layer and lymphoid cell infiltration in the dermis were observed. Diarrhea was observed at the same time although hyperbilirubinemia was not observed. This condition was diagnosed as grade 1 acute graft-versus-host disease. 75 days after transplantation, severe diarrhea and hyperbilirubinemia, over 19 mg/dl, were observed so that he was diagnosed as having grade 4 chronic graft-versus-host disease. At that moment he showed ichthyosiform highly scaly dry skin on almost the entire body, especially on the lower legs. The possibility of diagnosis of chronic skin graft-versus-host disease is discussed.
