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Am J Clin Dermatol ; 19(1): 33-50, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28656563

RESUMO

Graft-versus-host disease (GVHD) is an immunological reaction and a frequent complication following allogeneic hematopoietic stem cell transplantation. It is associated with high mortality rates and may have a significant negative impact on the patient's quality of life, particularly in the chronic-stage setting. Many different organs can be involved, which leads to a wide range of clinical manifestations. In this context, dermatologists play a key role by diagnosing and treating GVHD from the outset since cutaneous features are not just the most common but are also usually the presenting sign. Several skin-direct therapies are available and may be indicated as monotherapy or adjuvant treatment in order to allow faster tapering and withdrawal of systemic immunosuppression. Treatment of steroid-refractory patients remains a challenge and, to date, no consensus has been reached for one single agent in second-line therapy. This article aims to review skin involvement as well as provide and update discussion on therapeutic options for both acute and chronic cutaneous GVHD.


Assuntos
Fármacos Dermatológicos/uso terapêutico , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Terapia de Imunossupressão/métodos , Dermatopatias/terapia , Doença Aguda/terapia , Administração Cutânea , Administração Intravenosa , Administração Oral , Biomarcadores/análise , Doença Crônica/terapia , Glucocorticoides/uso terapêutico , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/imunologia , Doença Enxerto-Hospedeiro/mortalidade , Humanos , Qualidade de Vida , Pele/imunologia , Dermatopatias/diagnóstico , Dermatopatias/imunologia , Dermatopatias/mortalidade
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