Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation

Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kaminska-Winciorek, Grażyna [verfasserIn] Zalaudek, Iris [verfasserIn] Mendrek, Włodzimierz [verfasserIn] Jaworska, Magdalena [verfasserIn] Gajda, Maksymilian [verfasserIn] Hołowiecki, Jerzy [verfasserIn] Szymszal, Jan [verfasserIn] Giebel, Sebastian [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Cutaneous graft-versus-host-disease Dermoscopy Hematopoietic allogeneic stem cell transplantation

Übergeordnetes Werk:	Enthalten in: Dermatology and therapy - Heidelberg : Springer, 2011, 10(2020), 5 vom: 16. Juli, Seite 1043-1061
Übergeordnetes Werk:	volume:10 ; year:2020 ; number:5 ; day:16 ; month:07 ; pages:1043-1061

Links:	Volltext

DOI / URN:	10.1007/s13555-020-00423-6

Katalog-ID:	SPR040888886

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520			\|a Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD.
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allfields	10.1007/s13555-020-00423-6 doi (DE-627)SPR040888886 (SPR)s13555-020-00423-6-e DE-627 ger DE-627 rakwb eng 610 ASE Kaminska-Winciorek, Grażyna verfasserin aut Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213 Zalaudek, Iris verfasserin aut Mendrek, Włodzimierz verfasserin aut Jaworska, Magdalena verfasserin aut Gajda, Maksymilian verfasserin aut Hołowiecki, Jerzy verfasserin aut Szymszal, Jan verfasserin aut Giebel, Sebastian verfasserin aut Enthalten in Dermatology and therapy Heidelberg : Springer, 2011 10(2020), 5 vom: 16. Juli, Seite 1043-1061 (DE-627)723900000 (DE-600)2680284-3 2190-9172 nnns volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061 https://dx.doi.org/10.1007/s13555-020-00423-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 5 16 07 1043-1061
spelling	10.1007/s13555-020-00423-6 doi (DE-627)SPR040888886 (SPR)s13555-020-00423-6-e DE-627 ger DE-627 rakwb eng 610 ASE Kaminska-Winciorek, Grażyna verfasserin aut Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213 Zalaudek, Iris verfasserin aut Mendrek, Włodzimierz verfasserin aut Jaworska, Magdalena verfasserin aut Gajda, Maksymilian verfasserin aut Hołowiecki, Jerzy verfasserin aut Szymszal, Jan verfasserin aut Giebel, Sebastian verfasserin aut Enthalten in Dermatology and therapy Heidelberg : Springer, 2011 10(2020), 5 vom: 16. Juli, Seite 1043-1061 (DE-627)723900000 (DE-600)2680284-3 2190-9172 nnns volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061 https://dx.doi.org/10.1007/s13555-020-00423-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 5 16 07 1043-1061
allfields_unstemmed	10.1007/s13555-020-00423-6 doi (DE-627)SPR040888886 (SPR)s13555-020-00423-6-e DE-627 ger DE-627 rakwb eng 610 ASE Kaminska-Winciorek, Grażyna verfasserin aut Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213 Zalaudek, Iris verfasserin aut Mendrek, Włodzimierz verfasserin aut Jaworska, Magdalena verfasserin aut Gajda, Maksymilian verfasserin aut Hołowiecki, Jerzy verfasserin aut Szymszal, Jan verfasserin aut Giebel, Sebastian verfasserin aut Enthalten in Dermatology and therapy Heidelberg : Springer, 2011 10(2020), 5 vom: 16. Juli, Seite 1043-1061 (DE-627)723900000 (DE-600)2680284-3 2190-9172 nnns volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061 https://dx.doi.org/10.1007/s13555-020-00423-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 5 16 07 1043-1061
allfieldsGer	10.1007/s13555-020-00423-6 doi (DE-627)SPR040888886 (SPR)s13555-020-00423-6-e DE-627 ger DE-627 rakwb eng 610 ASE Kaminska-Winciorek, Grażyna verfasserin aut Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213 Zalaudek, Iris verfasserin aut Mendrek, Włodzimierz verfasserin aut Jaworska, Magdalena verfasserin aut Gajda, Maksymilian verfasserin aut Hołowiecki, Jerzy verfasserin aut Szymszal, Jan verfasserin aut Giebel, Sebastian verfasserin aut Enthalten in Dermatology and therapy Heidelberg : Springer, 2011 10(2020), 5 vom: 16. Juli, Seite 1043-1061 (DE-627)723900000 (DE-600)2680284-3 2190-9172 nnns volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061 https://dx.doi.org/10.1007/s13555-020-00423-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 5 16 07 1043-1061
allfieldsSound	10.1007/s13555-020-00423-6 doi (DE-627)SPR040888886 (SPR)s13555-020-00423-6-e DE-627 ger DE-627 rakwb eng 610 ASE Kaminska-Winciorek, Grażyna verfasserin aut Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD. Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213 Zalaudek, Iris verfasserin aut Mendrek, Włodzimierz verfasserin aut Jaworska, Magdalena verfasserin aut Gajda, Maksymilian verfasserin aut Hołowiecki, Jerzy verfasserin aut Szymszal, Jan verfasserin aut Giebel, Sebastian verfasserin aut Enthalten in Dermatology and therapy Heidelberg : Springer, 2011 10(2020), 5 vom: 16. Juli, Seite 1043-1061 (DE-627)723900000 (DE-600)2680284-3 2190-9172 nnns volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061 https://dx.doi.org/10.1007/s13555-020-00423-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 5 16 07 1043-1061
language	English
source	Enthalten in Dermatology and therapy 10(2020), 5 vom: 16. Juli, Seite 1043-1061 volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061
sourceStr	Enthalten in Dermatology and therapy 10(2020), 5 vom: 16. Juli, Seite 1043-1061 volume:10 year:2020 number:5 day:16 month:07 pages:1043-1061
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Cutaneous graft-versus-host-disease Dermoscopy Hematopoietic allogeneic stem cell transplantation
dewey-raw	610
isfreeaccess_bool	true
container_title	Dermatology and therapy
authorswithroles_txt_mv	Kaminska-Winciorek, Grażyna @@aut@@ Zalaudek, Iris @@aut@@ Mendrek, Włodzimierz @@aut@@ Jaworska, Magdalena @@aut@@ Gajda, Maksymilian @@aut@@ Hołowiecki, Jerzy @@aut@@ Szymszal, Jan @@aut@@ Giebel, Sebastian @@aut@@
publishDateDaySort_date	2020-07-16T00:00:00Z
hierarchy_top_id	723900000
dewey-sort	3610
id	SPR040888886
language_de	englisch
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Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). 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author	Kaminska-Winciorek, Grażyna
spellingShingle	Kaminska-Winciorek, Grażyna ddc 610 misc Cutaneous graft-versus-host-disease misc Dermoscopy misc Hematopoietic allogeneic stem cell transplantation Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation
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topic_title	610 ASE Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation Cutaneous graft-versus-host-disease (dpeaa)DE-He213 Dermoscopy (dpeaa)DE-He213 Hematopoietic allogeneic stem cell transplantation (dpeaa)DE-He213
topic	ddc 610 misc Cutaneous graft-versus-host-disease misc Dermoscopy misc Hematopoietic allogeneic stem cell transplantation
topic_unstemmed	ddc 610 misc Cutaneous graft-versus-host-disease misc Dermoscopy misc Hematopoietic allogeneic stem cell transplantation
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title	Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation
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title_full	Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation
author_sort	Kaminska-Winciorek, Grażyna
journal	Dermatology and therapy
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author_browse	Kaminska-Winciorek, Grażyna Zalaudek, Iris Mendrek, Włodzimierz Jaworska, Magdalena Gajda, Maksymilian Hołowiecki, Jerzy Szymszal, Jan Giebel, Sebastian
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author-letter	Kaminska-Winciorek, Grażyna
doi_str_mv	10.1007/s13555-020-00423-6
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title_sort	dermoscopy of cutaneous graft-versus-host-disease in patients after allogeneic hematopoietic stem cell transplantation
title_auth	Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation
abstract	Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD.
abstractGer	Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD.
abstract_unstemmed	Introduction Progress in the transplant procedure has resulted in a higher proportion of patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. Consecutive skin biopsies for histopathologic analysis were obtained from the suspected skin locations determined during dermoscopy. Results Graft-versus-host disease was confirmed by histopathology in 19 of the 20 allo-HSCT recipients. Four patients developed symptoms of acute cutaneous GvHD (grade 1, n = 2; grade 2, n = 1; grade 3, n = 1), and 15 patients developed chronic cutaneous GvHD. The most frequent dermoscopic signs (irrespective of whether GvHD was chronic or acute) were vessels and scaling (both n = 14, 73.7%). Hyperpigmentation and white patchy areas were present in eight patients (42.1%). Fair to moderate levels of agreement were found between presence of melanophages in the skin sample and dermoscopic granularity (Cohen’s Kappa [κ] = 0.39), scaling (κ = − 0.3) and vessels (κ = − 0.42). The finding of white patchy areas was inversely associated with lymphocytic infiltration (κ = − 0.55). Conclusion The results of this study suggest that dermoscopy may be a useful tool for diagnosing cutaneous GvHD in allo-HSCT recipients. Combining the clinical picture with dermoscopic features may bring us closer to a faster and easier diagnosis of GvHD.
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title_short	Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation
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author2	Zalaudek, Iris Mendrek, Włodzimierz Jaworska, Magdalena Gajda, Maksymilian Hołowiecki, Jerzy Szymszal, Jan Giebel, Sebastian
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Cutaneous graft-versus-host disease (GvHD) occurs often among patients who have undergone allo-HSCT. Routine diagnosis of skin and mucosal lesions is based primarily on clinical evaluation and histopathologic confirmation of skin biopsies. However, biopsy is an invasive method and histopathologic analysis is time-consuming, often accompanied by a lack of clinical correlation. There is therefore an urgent need for non-invasive, reproducible in vivo imaging methods that could be used in patients with cutaneous GvHD—both in the setting of initial diagnosis and during follow-up.The aim of the study reported here was to determine the role of dermoscopic monitoring of skin lesions in allo-HSCT recipients with consecutive histopathologic support as a non-invasive, alternative method to diagnose GvHD. Methods Twenty patients were examined by dermoscopy upon the manifestation of skin changes in the course of GvHD. 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Dermoscopy of Cutaneous Graft-Versus-Host-Disease in Patients After Allogeneic Hematopoietic Stem Cell Transplantation

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