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

AIM: To determine the frequency and the characteristics of cutaneous manifestations, especially vitiligo and alopecia areata, in patients with chronic graft-vs-host disease (cGVHD). METHODS: 50 patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by an ex...

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Autores principales: 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, Pavletic, Steven Z
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Medical Schools 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937222/
https://www.ncbi.nlm.nih.gov/pubmed/27374824
http://dx.doi.org/10.3325/cmj.2016.57.229
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author 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
Pavletic, Steven Z
author_facet 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
Pavletic, Steven Z
author_sort Čeović, Romana
collection PubMed
description AIM: To determine the frequency and the characteristics of cutaneous manifestations, especially vitiligo and alopecia areata, in patients with chronic graft-vs-host disease (cGVHD). METHODS: 50 patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by an experienced dermatologist. The evaluation was focused on the clinical spectrum of skin and adnexal involvement, and the cutaneous GVHD score was determined according to National Institutes of Health (NIH) Consensus criteria. The presence of vitiligo, alopecia, xerosis, nail changes, and dyspigmentation was also assessed. RESULTS: Out of 50 cGVHD patients, 28 (56%) had skin involvement, and 27 of them (96%) had hypo and/or hyperpigmentations. 11 patients (39%) had a mild cutaneous NIH cGVHD score, 22% moderate, and 39% severe. 15 (30%) patients had nail changes and 10 (20%) had vitiligo or alopecia areata. Univariate analysis showed that patients with vitiligo/alopecia areata received more lines of prior systemic immunosuppressive therapy (P = 0.043), had lower Karnofsky performance status (P = 0.028), and had a higher B-cell number (P = 0.005), platelet count (P = 0.022), and total protein (P = 0.024). Vitiligo and alopecia areata were associated with higher NIH skin score (P = 0.001), higher intensity of immunosuppressive treatment (P = 0.020), and total body irradiation conditioning (P = 0.040). Multivariate regression model showed that patients with higher NIH skin scoring were 3.67 times more likely to have alopecia and/or vitiligo (odds ratio 3.67; 95% confidence interval 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 previously reported.
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spelling pubmed-49372222016-07-18 High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease 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 Pavletic, Steven Z Croat Med J Graft-VS-Host Disease AIM: To determine the frequency and the characteristics of cutaneous manifestations, especially vitiligo and alopecia areata, in patients with chronic graft-vs-host disease (cGVHD). METHODS: 50 patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by an experienced dermatologist. The evaluation was focused on the clinical spectrum of skin and adnexal involvement, and the cutaneous GVHD score was determined according to National Institutes of Health (NIH) Consensus criteria. The presence of vitiligo, alopecia, xerosis, nail changes, and dyspigmentation was also assessed. RESULTS: Out of 50 cGVHD patients, 28 (56%) had skin involvement, and 27 of them (96%) had hypo and/or hyperpigmentations. 11 patients (39%) had a mild cutaneous NIH cGVHD score, 22% moderate, and 39% severe. 15 (30%) patients had nail changes and 10 (20%) had vitiligo or alopecia areata. Univariate analysis showed that patients with vitiligo/alopecia areata received more lines of prior systemic immunosuppressive therapy (P = 0.043), had lower Karnofsky performance status (P = 0.028), and had a higher B-cell number (P = 0.005), platelet count (P = 0.022), and total protein (P = 0.024). Vitiligo and alopecia areata were associated with higher NIH skin score (P = 0.001), higher intensity of immunosuppressive treatment (P = 0.020), and total body irradiation conditioning (P = 0.040). Multivariate regression model showed that patients with higher NIH skin scoring were 3.67 times more likely to have alopecia and/or vitiligo (odds ratio 3.67; 95% confidence interval 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 previously reported. Croatian Medical Schools 2016-06 /pmc/articles/PMC4937222/ /pubmed/27374824 http://dx.doi.org/10.3325/cmj.2016.57.229 Text en Copyright © 2016 by the Croatian Medical Journal. All rights reserved. http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Graft-VS-Host Disease
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
Pavletic, Steven Z
High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title_full High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title_fullStr High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title_full_unstemmed High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title_short High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
title_sort high frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease
topic Graft-VS-Host Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937222/
https://www.ncbi.nlm.nih.gov/pubmed/27374824
http://dx.doi.org/10.3325/cmj.2016.57.229
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