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Kunishige, Joy H., MD; Hymes, Sharon R., MD; Madkan, Vandana, MD; Wyatt, Angela J., MD; Uptmore, David, MD; Lazar, Alexander J.F., MD, PhD; Giralt, Sergio, MD; Rady, Peter, MD, PhD; Tyring, Stephen, MD, PhD, MBA
Journal of the American Academy of Dermatology, 11/2007, Volume: 57, Issue: 5Journal Article
We report a case of epidermodysplasia verruciformis (EV)-like lesions in a patient with graft-versus-host disease after peripheral blood stem cell transplantation from his HLA-matched brother. The patient presented with a diffuse papular eruption that was clinically consistent with graft-versus-host disease; however, histopathology demonstrated viral cytopathic changes and polymerase chain reaction confirmed EV human papillomavirus types 8 and 20. Repeated biopsy specimen showed both human papillomavirus cytopathic effect and graft-versus-host disease, and further workup revealed ocular and hepatic involvement. This progressed to a lupuslike syndrome with lichenoid, violaceous, flat-topped papules in a malar distribution and positive antinuclear autoantibodies. Although EV-like lesions have been reported in patients who are immunocompromised, the incidence is low, and may be linked to EV-related haplotypes.
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