LICHENOID CHRONIC GRAFT-VS-HOST DISEASE OCCURRING IN A DERMATOMAL DISTRIBUTION

Background: Chronic graft-vs-host disease (GVHD) is a late complicatio n of allogeneic bone marrow transplantation and is associated with hig h morbidity and mortality, While the pathogenesis of chronic GVHD is n ot fully understood, several observations and studies suggest that vir al infections may play a role. We describe two patients who developed linear lichenoid chronic GVHD. The dermatomal distribution of their le sions suggests an association with herpes zoster virus infection. Obse rvations: Two allogeneic bone marrow transplantation patients develope d violaceous papules in a dermatomal distribution. Histologic examinat ion of these lesions revealed dyskeratosis, vacuolar changes in the ba sal layer, and a mild perivascular and interstitial infiltrate, diagno stic of lichenoid chronic GVHD. Conclusions: The linear distribution o f our patients' lichenoid chronic GVHD is unique and may represent an association with herpes zoster virus infection, providing further supp ort for a role for viral infections in the pathogenesis of chronic GVH D.