Q J Med 1993; 86: 715-717
© 1993 Association of Physicians
research-article |
The role of skin biopsies in bone marrow transplant recipients
1From the Departments of Dermatology, The Royal Infirmary Edinburgh, UK 2From the Pathology, The Royal Infirmary Edinburgh, UK 3From the Haematology, The Royal Infirmary Edinburgh, UK
Address correspondence to Dr N. C. Hepburn, Department of Dermatology, Level 4, Lauriston Building, The Royal Infirmary, Edinburgh EH3 9YW
Received 20 July 1993 Accepted for publication 19 August 1993.
Bone marrow transplant (BMT) recipients frequently develop rashes as a consequence of their disease, its treatment or because of a complication such as infection. These rashes are often clinically atypical, yet appropriate management is dependent upon correct diagnosis and therefore a skin biopsy is often performed. In a group of 101 consecutive BMT recipients, 25 patients had a total of 34 skin biopsies. A specific histopathological diagnosis was made in 65% (22/34), including graft vs. host disease (GVHD) (15 cases), infection (4 cases), drug reaction (1 case) and recurrent lymphoma (1 case). Therapy was changed following the biopsy in 77% (17/22) of these cases. In 35% (12/34) the histological changes were non-specific, however, in 10 of these cases GVHD had been suspected clinically and its exclusion was therefore useful. Skin biopsy is of considerable value in the diagnosis and subsequent management of BMT recipients who develop a rash.