Dermatologic Conditions of the Early Post-Transplant Period in Hematopoietic Stem Cell Transplant Recipients

The document from 2018 reviews dermatologic conditions in the early post-transplant period for hematopoietic stem cell transplant (HSCT) recipients. It emphasizes the frequency of skin eruptions post-HSCT, affecting 67% of patients in one study of 137 allogeneic HSCT recipients, and the role of dermatologists in changing diagnosis and/or management in 65% of cases. The review covers conditions like Erythema of the Leukemic Rash (ELR), Acute Graft-versus-Host Disease (aGVHD), with a 5-year leukemia-free survival rate ranging from 63% for grade I to 8% for grade IV, and drug-related cutaneous reactions such as Morbilliform Drug Eruptions (MDEs). It also discusses severe conditions like Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) with a mortality rate over 30% for TEN, and the importance of early diagnosis and treatment. Toxic erythema of chemotherapy (TEC), chemotherapy-induced hyperpigmentation, and infections like ecthyma gangrenosum (EG) and candidiasis are also mentioned, with a focus on early treatment to improve outcomes. Additionally, the document addresses late complications such as chronic graft-versus-host disease (cGVHD) and increased skin cancer risk in allogeneic HSCT recipients, highlighting the critical role of dermatologists in managing these conditions.