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Table of Contents
Vol. 210, No. 1, 2005
Issue release date: December 2004
Section title: Case Report
Dermatology 2005;210:68–71
(DOI:10.1159/000081489)

Chronic Graft-versus-Host-Disease-Like Dermopathy in a Child with CD4+ Cell Microchimerism

Kowalzick L.a · Artlett C.M.d · Thoss K.b · Baum H.-P.c · Ziegler H.a · Mischke D.a · Blum R.a · Pönnighaus J.-M.a · Quietzsch J.b
Departments of aDermatology and Allergology and bPediatric and Adolescence Medicine, Humaine Vogtland-Klinikum Plauen, Plauen, and cInstitute for Pathology, Zweibrücken, Germany; dDivision of Rheumatology, Thomas Jefferson University, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: May 06, 2004
Published online: January 28, 2005
Issue release date: December 2004

Number of Print Pages: 4
Number of Figures: 3
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM

Abstract

We report the case of an 11-year-old boy suffering from a severe progressive chronic skin disease with clinical features of progressive systemic scleroderma, systemic lupus erythematosus and dermatomyositis. Skin biopsies revealed fibrosis and lichenoid changes and muscle biopsy a myositis. Immunohistology of the skin showed a lichen-ruber-like pattern. Despite repeated extensive investigations, no autoantibodies were detectable. Some of these findings looked like those described in juvenile dermatomyositis. Finally, it could be demonstrated that the boy showed microchimerism with approximately 1% maternal CD4+ lymphocytes in his peripheral blood leukocytes. Furthermore maternal cells could be demonstrated in inflamed muscle tissue. So a graft-versus-host-disease-like pathomechanism appears to be likely. Several systemic therapies have been used with limited success to improve the condition including corticosteroids, azathioprine, cyclosporine A and mycophenolate mofetil. A distinct improvement of erythemas and sclerosis could be achieved by means of low-dose UVA1 phototherapy which was applied with escalating single doses of 3–12 J/cm2 for 35 consecutive days.

© 2005 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Case Report

Received: May 06, 2004
Published online: January 28, 2005
Issue release date: December 2004

Number of Print Pages: 4
Number of Figures: 3
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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