Chronic Graft-Versus-Host Disease: The Hidden Impact of Cutaneous Ulcers - European Medical Journal Chronic Graft-Versus-Host Disease: The Hidden Impact of Cutaneous Ulcers - AMJ

Chronic Graft-Versus-Host Disease: The Hidden Impact of Cutaneous Ulcers

CUTANEOUS ulcers present a significant challenge in the management of chronic graft-versus-host disease (cGVHD), a complication that affects patients who have undergone allogeneic hematopoietic cell transplantation. A recent systematic review delves into the clinical features and treatments of these ulcers, highlighting their impact on patient quality of life.

The review analyzed 16 studies, including 65 patients, to assess the occurrence and characteristics of cutaneous ulcers in cGVHD. The mean age of patients was 35.7 years, with the majority (66%) being male. These ulcers often appear several years after hematopoietic cell transplantation, with an average onset time of 37 months, though the range varied widely from as early as 4 months to as late as 204 months.

Patients typically present with multiple ulcers, often symmetrically located in areas of sclerotic skin involvement. Nearly all patients (98%) experienced sclerotic cGVHD, and the lower limbs were the most common site for ulcers (84%), followed by the trunk (29%) and upper limbs (22%). Pain was the most frequent symptom associated with these ulcers, which also had a high incidence of secondary infections (32%). In some severe cases, sepsis from the ulcers resulted in death.

Effective management strategies for these ulcers remain a crucial area of clinical focus, given the impact on the patient’s physical well-being and the risk of complications like infection and sepsis. This systematic review underscores the need for clinicians to closely monitor and treat cutaneous ulcers in cGVHD patients to reduce their morbidity and improve long-term outcomes.

Reference:
Nguyen TM et al. Cutaneous ulcers in patients with chronic graft-versus-host disease: A systematic review. JAAD Rev. 2025;4:175-177.

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