Case reports
Chronic Graft-Versus-Host Disease Presenting as Bullous Lesions
Lesiones Ampollosas Como Forma de Presentación de una Enfermedad de Injerto Contra Huésped Crónica
J. del Pozoa,
, J. García-Silvaa, M.T. Yebra-Pimentelb
Autor para correspondencia
del_pozo@canalejo.org
Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain.
Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain.
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"apellidos" => "Camacho" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703688?idApp=UINPBA000044" "url" => "/15782190/0000009900000010/v1_201304241444/S1578219008703688/v1_201304241444/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case reports</span>" "titulo" => "Chronic Graft-Versus-Host Disease Presenting as Bullous Lesions" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "803" "paginaFinal" => "807" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. del Pozo, J. García-Silva, M.T. Yebra-Pimentel" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "del Pozo" "email" => array:1 [ 0 => "del_pozo@canalejo.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "García-Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "M.T." "apellidos" => "Yebra-Pimentel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones Ampollosas Como Forma de Presentación de una Enfermedad de Injerto Contra Huésped Crónica" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2007-12-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84336" "palabras" => array:2 [ 0 => "chronic graft-vs-host disease" 1 => "bullous lesions" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84335" "palabras" => array:2 [ 0 => "enfermedad injerto contra huésped crónica" 1 => "lesiones ampollosas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Graft-vs-host disease is still the leading cause of morbidity and mortality in patients undergoing bone marrow transplantation. It is important to start treatment early to reduce the severity and consequences of this complication. Cutaneous lesions are often the presenting compliant of graft-vs-host disease and presage visceral involvement.</p><p class="elsevierStyleSimplePara elsevierViewall">We present the case of a 45-year-old woman with multiple myeloma who underwent autologous and subsequently allogeneic bone marrow transplantation with hematopoietic precursors. She developed bullous lesions with fluid elimination on the abdomen and legs. Biopsy findings were compatible with graft-vs-host disease and immunosuppressive therapy was increased. She subsequently presented oral lichenoid lesions and sicca syndrome. The bullous lesions progressed to painful ulcers that healed leaving highly sclerodermatous skin with substantial hyperpigmentation.</p><p class="elsevierStyleSimplePara elsevierViewall">Bullous lesions are a rare form of presentation of chronic graft-vs-host disease. In such cases, the diagnosis may not be suspected initially, particularly when the lesions are isolated and internal organs are not involved.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La enfermedad de injerto contra huésped (EICH) continúa siendo la primera causa de morbilidad y mortalidad en los enfermos con trasplante de médula ósea, de modo que un tratamiento precoz es importante para reducir la gravedad y las consecuencias de esta complicación.</p><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones cutáneas son en muchas ocasiones la forma de presentación de una EICH y anuncian la afectación visceral.</p><p class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una paciente de 45 años con mieloma múltiple a la que se realizó primero un trasplante autólogo y posteriormente un trasplante alogénico de médula ósea con precursores hematopoyéticos. Desarrolló lesiones ampollosas con eliminación de líquido en el abdomen y los miembros inferiores. Se realizó una biopsia que fue compatible con una EICH y se aumentó el tratamiento inmunodepresor. La paciente posteriormente presentó lesiones liquenoides orales, síndrome seco y las lesiones ampollosas que evolucionaron a úlceras dolorosas, que cicatrizaron con un intenso aspecto esclerodermiforme e importante hiperpigmentación.</p><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones ampollosas son una forma de presentación excepcional en la EICH crónica, y en estos casos la sospecha inicial del diagnóstico puede ser difícil, sobre todo cuando se presentan de forma aislada sin afectación de órganos internos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 8 | 9 | 17 |
| 2024 Octubre | 52 | 42 | 94 |
| 2024 Septiembre | 42 | 32 | 74 |
| 2024 Agosto | 80 | 63 | 143 |
| 2024 Julio | 45 | 80 | 125 |
| 2024 Junio | 54 | 79 | 133 |
| 2024 Mayo | 44 | 35 | 79 |
| 2024 Abril | 48 | 35 | 83 |
| 2024 Marzo | 53 | 45 | 98 |
| 2024 Febrero | 40 | 40 | 80 |
| 2024 Enero | 40 | 44 | 84 |
| 2023 Diciembre | 46 | 50 | 96 |
| 2023 Noviembre | 46 | 43 | 89 |
| 2023 Octubre | 39 | 30 | 69 |
| 2023 Septiembre | 36 | 22 | 58 |
| 2023 Agosto | 26 | 16 | 42 |
| 2023 Julio | 26 | 62 | 88 |
| 2023 Junio | 35 | 25 | 60 |
| 2023 Mayo | 30 | 27 | 57 |
| 2023 Abril | 19 | 37 | 56 |
| 2023 Marzo | 21 | 31 | 52 |
| 2023 Febrero | 22 | 32 | 54 |
| 2023 Enero | 17 | 42 | 59 |
| 2022 Diciembre | 26 | 42 | 68 |
| 2022 Noviembre | 15 | 25 | 40 |
| 2022 Octubre | 14 | 18 | 32 |
| 2022 Septiembre | 13 | 51 | 64 |
| 2022 Agosto | 20 | 38 | 58 |
| 2022 Julio | 14 | 22 | 36 |
| 2022 Junio | 20 | 33 | 53 |
| 2022 Mayo | 19 | 38 | 57 |
| 2022 Abril | 30 | 46 | 76 |
| 2022 Marzo | 28 | 62 | 90 |
| 2022 Febrero | 12 | 21 | 33 |
| 2022 Enero | 24 | 55 | 79 |
| 2021 Diciembre | 14 | 42 | 56 |
| 2021 Noviembre | 17 | 50 | 67 |
| 2021 Octubre | 24 | 45 | 69 |
| 2021 Septiembre | 24 | 48 | 72 |
| 2021 Agosto | 12 | 30 | 42 |
| 2021 Julio | 19 | 29 | 48 |
| 2021 Junio | 22 | 34 | 56 |
| 2021 Mayo | 18 | 35 | 53 |
| 2021 Abril | 47 | 59 | 106 |
| 2021 Marzo | 46 | 28 | 74 |
| 2021 Febrero | 31 | 21 | 52 |
| 2021 Enero | 28 | 26 | 54 |
| 2020 Diciembre | 23 | 11 | 34 |
| 2020 Noviembre | 20 | 21 | 41 |
| 2020 Octubre | 23 | 20 | 43 |
| 2020 Septiembre | 26 | 14 | 40 |
| 2020 Agosto | 21 | 23 | 44 |
| 2020 Julio | 27 | 11 | 38 |
| 2020 Junio | 9 | 24 | 33 |
| 2020 Mayo | 26 | 27 | 53 |
| 2020 Abril | 21 | 20 | 41 |
| 2020 Marzo | 13 | 27 | 40 |
| 2020 Febrero | 1 | 9 | 10 |
| 2020 Enero | 0 | 14 | 14 |
| 2019 Diciembre | 0 | 8 | 8 |
| 2019 Noviembre | 0 | 7 | 7 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 0 | 7 | 7 |
| 2019 Agosto | 0 | 2 | 2 |
| 2019 Julio | 0 | 8 | 8 |
| 2019 Junio | 0 | 3 | 3 |
| 2019 Mayo | 0 | 47 | 47 |
| 2019 Abril | 0 | 24 | 24 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Febrero | 0 | 5 | 5 |
| 2019 Enero | 0 | 1 | 1 |
| 2018 Diciembre | 0 | 5 | 5 |
| 2018 Noviembre | 0 | 3 | 3 |
| 2018 Septiembre | 0 | 3 | 3 |
| 2018 Agosto | 0 | 6 | 6 |
| 2018 Julio | 0 | 4 | 4 |
| 2018 Junio | 0 | 4 | 4 |
| 2018 Mayo | 0 | 6 | 6 |
| 2018 Abril | 0 | 12 | 12 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 7 | 7 | 14 |
| 2018 Enero | 10 | 9 | 19 |
| 2017 Diciembre | 14 | 14 | 28 |
| 2017 Noviembre | 15 | 11 | 26 |
| 2017 Octubre | 7 | 12 | 19 |
| 2017 Septiembre | 14 | 9 | 23 |
| 2017 Agosto | 18 | 11 | 29 |
| 2017 Julio | 32 | 10 | 42 |
| 2017 Junio | 28 | 20 | 48 |
| 2017 Mayo | 24 | 11 | 35 |
| 2017 Abril | 26 | 17 | 43 |
| 2017 Marzo | 30 | 13 | 43 |
| 2017 Febrero | 13 | 18 | 31 |
| 2017 Enero | 9 | 19 | 28 |
| 2016 Diciembre | 24 | 13 | 37 |
| 2016 Noviembre | 22 | 22 | 44 |
| 2016 Octubre | 24 | 14 | 38 |
| 2016 Septiembre | 33 | 16 | 49 |
| 2016 Agosto | 32 | 6 | 38 |
| 2016 Julio | 20 | 2 | 22 |
| 2016 Junio | 9 | 10 | 19 |
| 2016 Mayo | 7 | 4 | 11 |
| 2016 Abril | 8 | 11 | 19 |
| 2016 Marzo | 2 | 17 | 19 |
| 2016 Febrero | 9 | 19 | 28 |
| 2016 Enero | 6 | 19 | 25 |
| 2015 Diciembre | 9 | 13 | 22 |
| 2015 Noviembre | 11 | 23 | 34 |
| 2015 Octubre | 8 | 29 | 37 |
| 2015 Septiembre | 5 | 14 | 19 |
| 2015 Agosto | 11 | 13 | 24 |
| 2015 Julio | 29 | 38 | 67 |
| 2015 Junio | 33 | 26 | 59 |
| 2015 Mayo | 53 | 37 | 90 |
| 2015 Abril | 42 | 26 | 68 |
| 2015 Marzo | 46 | 18 | 64 |
| 2015 Febrero | 24 | 16 | 40 |
| 2015 Enero | 25 | 11 | 36 |
| 2014 Diciembre | 29 | 10 | 39 |
| 2014 Noviembre | 33 | 13 | 46 |
| 2014 Octubre | 31 | 20 | 51 |
| 2014 Septiembre | 42 | 24 | 66 |
| 2014 Agosto | 42 | 19 | 61 |
| 2014 Julio | 36 | 27 | 63 |
| 2014 Junio | 50 | 17 | 67 |
| 2014 Mayo | 40 | 23 | 63 |
| 2014 Abril | 50 | 13 | 63 |
| 2014 Marzo | 71 | 23 | 94 |
| 2014 Febrero | 35 | 26 | 61 |
| 2014 Enero | 46 | 16 | 62 |
| 2013 Diciembre | 44 | 19 | 63 |
| 2013 Noviembre | 33 | 27 | 60 |
| 2013 Octubre | 34 | 40 | 74 |
| 2013 Septiembre | 33 | 24 | 57 |
| 2013 Agosto | 28 | 34 | 62 |
| 2013 Julio | 48 | 34 | 82 |
| 2013 Junio | 35 | 42 | 77 |
| 2013 Mayo | 27 | 39 | 66 |
| 2013 Abril | 18 | 38 | 56 |
| 2013 Marzo | 27 | 25 | 52 |
| 2013 Febrero | 32 | 15 | 47 |
| 2013 Enero | 16 | 5 | 21 |
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