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Chronic graft-versus-host disease - Nail and Distal Digit
See also in: Overview,Oral Mucosal Lesion
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Chronic graft-versus-host disease - Nail and Distal Digit

See also in: Overview,Oral Mucosal Lesion
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Contributors: Philip I. Song MD, Susan Burgin MD, Ivy Lee MD, Jonathan Cotliar MD
Other Resources UpToDate PubMed

Synopsis

Graft-versus-host disease (GVHD) is a T-cell-mediated inflammatory disorder that occurs after allogenic hematopoietic cell (bone marrow) transplantation, which usually affects the skin, mucosa, conjunctiva, gastrointestinal tract, genital mucosa, liver, and lungs. Immunoactive T-cells from the donated marrow (graft) attack "foreign" antigens in the marrow recipient (host).

Multiple nail findings can be seen in both the acute and chronic forms of GVHD; findings in the chronic form are more common. Acute GVHD is associated with periungual erythema or a violaceous hue of the surrounding tissues; onychomadesis is also possible. Nail alterations occur in 20%-50% of patients with chronic GVHD, and other skin findings are commonly seen. The most common nail finding is longitudinal ridging with nail alterations typically resembling the nail changes seen in lichen planus. The presence or absence of nail alterations is not predicted by the clinical severity of GVHD. However, a higher incidence and severity of nail changes has been reported to occur in patients with a longer period of the disease.

Codes

ICD10CM:
D89.811 – Chronic graft-versus-host disease

SNOMEDCT:
402356004 – Chronic graft-versus-host disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Differential diagnoses for chronic GVHD include the following:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 02/02/2017
Last Updated: 02/02/2017
Copyright © 2019 VisualDx®. All rights reserved.
Chronic graft-versus-host disease - Nail and Distal Digit
See also in: Overview,Oral Mucosal Lesion
Print 3 Images
View all Images (3)
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Chronic graft-versus-host disease : Alkaline phosphatase elevated, ALT elevated, AST elevated, Lower extremity edema, Nail fold erythema and edema, Oral white plaque, Arthralgia, Dry eyes, Dry mouth, Hardened skin, Scaly plaques
Clinical image of Chronic graft-versus-host disease
Copyright © 2019 VisualDx®. All rights reserved.