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Facial rash mimicking cutaneous acute graft-versus-host disease after allogeneic stem cell transplantation for osteomyelofibrosis – was Demodex the culprit?

Bone Marrow Transplantation volume 37, pages 711–712 (2006)Cite this article

The most important differential diagnosis of facial erythema within the first 100 days after allogeneic stem cell transplantation is the cutaneous manifestation of acute graft-versus-host disease (aGvHD).1 Other reasons for exanthema are allergic reactions or toxicity of conditioning therapy. However, even rare diagnoses should be considered in the differential diagnoses for aGvHD.

Demodicosis (pityriasis folliculorum) is an independent clinical picture. This dermal inflammation manifests as diffuse erythema. Typically, there is focal involvement of the face. The initial report in 1961 suggested a prevalence of 95% of Demodex folliculorum. Making a clear diagnosis of the contribution of this mite to skin disease can sometimes be difficult. Demodicosis can be diagnosed by histology or other means along with clinical resolution with appropriate therapy.5, 6 In conclusion, early skin biopsy after allogeneic stem cell transplantation should be encouraged when the diagnosis of aGvHD is uncertain.

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Authors and Affiliations

  1. Internal Medicine C (Haematology and Oncology, Transplant Centre), Ernst-Moritz-Arndt-University, Greifswald, Germany

    C Lotze, W H Krüger, T Kiefer, F Schüler, C Busemann & G Dölken

  2. Dermatology and Venerology, Ernst-Moritz-Arndt-University, Greifswald, Germany

    O Swensson

  3. Institute for Pathology, Dietrich-Bonhoeffer Hospital, Neubrandenburg, Germany

    E W Herbst

Authors
  1. C Lotze
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  2. W H Krüger
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  3. T Kiefer
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  4. O Swensson
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  5. E W Herbst
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  6. F Schüler
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  7. C Busemann
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  8. G Dölken
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Correspondence to W H Krüger.

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Lotze, C., Krüger, W., Kiefer, T. et al. Facial rash mimicking cutaneous acute graft-versus-host disease after allogeneic stem cell transplantation for osteomyelofibrosis – was Demodex the culprit?. Bone Marrow Transplant 37, 711–712 (2006). https://doi.org/10.1038/sj.bmt.1705296

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  • DOI: https://doi.org/10.1038/sj.bmt.1705296

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