Graft-versus-host disease variety toxic epidermal necrolysis. Case report

Background: We present the case of a patient who underwent hematopoietic progenitor cell transplantation from a fully compatible unrelated donor and subsequently developed Grade IV skin graft-versus-host disease (GVHD) resembling toxic epidermal necrolysis (TEN). Clinical case: An 11-year-old female, post-transplantation of hematopoietic progenitor cells from a 100% compatible unrelated donor, developed rash-like skin lesions on the trunk and extremities on day +35. A skin biopsy revealed dermal atrophy, vacuolization of the basal layer, and confluent apoptotic keratinocytes with mononuclear inflammatory cells in the dermoepidermis, confirming the diagnosis of TENlike acute cutaneous GVHD. Conclusion: The patient experienced an 80% remission of symptoms following dynamic management of immunosuppressants.