[Cutaneous manifestations of graft versus host disease (author's transl)].

Skin is a target organ for Graft v Host Reaction (GvHR). Cutaneous changes sometimes are the first symptoms for GvHR. They offer the opportunity for its early recognition. They include: -- A primarily acute phase, as red maculopapular rash, on face, palms and soles, which can spread over large areas, resembling scarlatiniform rash. Some courses have resulted in severe epidermal necrolysis similar to Lyell syndrome. -- A chronic phase, described with a variable time of onset after the acute episode. Two stages have been recognised: -- the early chronic phase has a clinical and histological picture similar to Lichen Planus, a frequent dermatosis which is thought to be the result of a chronic immune injury against epidermis. As early phase is fading, an atrophic aspect of the skin may develop, whose severe type is described as Poïkiloderma. -- The late chronic phase, in which densification of dermal collagen is become the essential features. In some patients, sclerotic changes develop, which are resembling to scleroderma ones. The cutaneous manifestations of GvH Disease can be responsible for considerable morbidity, mortality and sequelles. They may serve as a biological model for several skin diseases.