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Total leukoderma and leukotrichia in a child after hematopoietic SCT: report of a case and review of the literature

Bone Marrow Transplantation volume 49, pages 460–462 (2014)Cite this article

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The development of widespread depigmentation is a rare post transplant phenomenon observed in patients undergoing hematopoietic SCT (HSCT). We report our experience with a pediatric patient who developed total leukoderma with leukotrichia following HSCT and review the literature on previously reported pediatric cases.

A 15-year-old boy with a history of X-linked SCID was presented to our dermatology clinic for evaluation. He had undergone HSCT at the age of 8 months with haploidentical T-cell depleted donor cells from his mother without pre transplant conditioning. His immediate post-transplant course was notable for grade three acute GVHD initially occurring on day +17, which was responsive to prednisone. Upon resolution of acute GVHD, his mother noted rapid and progressive whitening of his skin and hair. He had a history of numerous sunburns, even with minimal sun exposure. He subsequently developed chronic GVHD of the skin (localized sclerotic type), lungs, liver and the gastrointestinal tract. On presentation to our clinic, medications included IVIG once every three weeks, mycophenolate mofetil 750 mg twice daily, prednisone 20 mg daily, trimethoprim-sulfamethoxazole thrice weekly and voriconazole 200 mg twice daily. Immunosuppressive medications were employed for management of chronic visceral GVHD. He had never received treatment for skin depigmentation. There was no family history of vitiligo or other disease of melanocytes or melanin biosynthesis.

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Authors and Affiliations

  1. Harvard Combined Dermatology Residency Program, Boston, MA, USA

    V E Nambudiri & W G Tsiaras

  2. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    V E Nambudiri

  3. Department of Pathology, Boston Children’s Hospital, Boston, MA, USA

    B A Schmidt

  4. Division of Immunology, Dermatology Program, Boston Children’s Hospital, Boston, MA, USA

    J T Huang

  5. Department of Pediatric Hematology Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    J T Huang

Authors
  1. V E Nambudiri
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  2. W G Tsiaras
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  3. B A Schmidt
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  4. J T Huang
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Correspondence to J T Huang.

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Nambudiri, V., Tsiaras, W., Schmidt, B. et al. Total leukoderma and leukotrichia in a child after hematopoietic SCT: report of a case and review of the literature. Bone Marrow Transplant 49, 460–462 (2014). https://doi.org/10.1038/bmt.2013.200

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