Naslov
High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-versus-host disease

Autori
Čeović, Romana ; Desnica, Lana ; Pulanić, Dražen ; Serventi Seiwerth, Ranka ; Ilić, Ivana ; Grce, Magdalena ; Mravak Stipetić, Marinka ; Klepac Pulanić, Tajana ; Bilić, Ervina ; Bilić, Ernest ; Milošević, Milan ; Vrhovac, Radovan ; Nemet, Damir ; Pavletić, Steven Živko

Izvornik
Croatian medical journal (0353-9504) 57 (2016), 3; 229-238

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Cutaneous GVHD ; vitiligo ; alopecia areata ; xerosis

Sažetak
Aim: To show the frequency and characteristics of cutaneous manifestations, with emphasis on vitiligo and alopecia areata in patients with chronic graft-versus-host disease (cGVHD). Methods: Patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by a multidisciplinary team of specialists. Dermatologic evaluation was focused on clinical spectrum of skin and adnexal involvement in each patient, determining the cutaneous GVHD score according to NIH Consensus criteria. Other objective clinical parameters including the existence of vitiligo, alopecia, xerosis, nail changes and dyspigmentation were assessed in each patient. Results: Among fifty cGVHD patients, 28 (56%) had skin involvement, and twenty seven of them (96%) had hypo and/or hyperpigmentations. In 11 patients (39%) the cutaneous NIH cGVHD score was mild, in 22% moderate and in 39% severe. In the whole cohort, nail changes were observed in 15 (30%) patients, while 10 (20%) were diagnosed with vitiligo or alopecia areata. In the univariate analysis patients with vitiligo/alopecia areata received more lines of prior systemic immunosuppressive therapy (P=0.043) ; they had lower Karnofsky performance status (P=0.028), and had higher number of B- cells (P=0.005), platelet count (P=0.022), total protein (P=0.024). Vitiligo and alopecia areata were associated with higher NIH skin score (P=0.001), were receiving higher intensity of immunosuppressive treatment (P=0.020) and TBI conditioning (P=0.040). In a multivariate regression model patients with higher NIH skin scoring were 3.67 times more likely to have alopecia and/or vitiligo (OR=3.67 ; 95% CI=1.26-10.73), controlled for all other factors in the model (age at study entry, number of B-cells, platelet count and global NIH score). Conclusion: These data indicate that vitiligo and alopecia areata occur more frequently in cGVHD than reported previously.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA