RT Journal
A1 Moody MN, Kazakevich N, Smith JR, et al
T1 Sweat the small stuff: The importance of clinical-pathologic correlation in cutaneous gvhd following orthotopic liver transplant
JF Archives of Dermatology
JO Archives of Dermatology
YR 2011
FD November 1
VO 147
IS 11
SP 1345
OP 1346
DO 10.1001/archdermatol.2011.331
UL http://dx.doi.org/10.1001/archdermatol.2011.331
AB 
Graft vs host disease is seen in only 1% to 2% of orthotopic liver transplant (OLT) cases and has a mortality rate of 85% to 90%, although there are rare reports of spontaneous regression.2 The transplanted liver itself is spared in OLT-associated GVHD because it lacks host antigens and is actually the source of attacking lymphocytes.3 Typical OLT-associated GVHD is acute ( <100 days postoperatively) and often involves the skin.1 The characteristic skin eruption begins on the palms and soles as a maculopapular, red to violaceous eruption that spreads centripetally; it may progress to blisters, resembling toxic epidermal necrolysis in severe cases.1 On the other hand, cutaneous manifestations of chronic GVHD (>100 days postoperatively) are more variable, including psoriasiform, papulosquamous, lichenoid, poikiloderma, or pityriasis-like lesions.1 We report herein a case of post-OLT GVHD.