Columnar epidermal necrosis: A unique manifestation of transfusion- associated cutaneous graft-vs-host disease

Shinobu Saijo, Motoko Honda, Youji Sasahara, Tasuke Konno, Hachiro Tagami

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: In 1978, the first case of columnar epidermal necrosis was reported in a 6-year-old boy. There were scaly, partially vesicular or crusty, erythematous lesions mainly involving the extremities that histopathologically showed peculiar features of focal, total epidermal necrosis accompanied by a lichenoid tissue reaction. He developed the skin eruption after receiving a blood transfusion from his mother when he showed debility induced by vaccination with an alternated live measles virus vaccine. The lesions rapidly regressed after sun exposure. To our knowledge, there has been no report of a similar case despite such unique features. Observation: We encountered a similar case of columnar epidermal necrosis in a 15-year-old Japanese girl with chronic graft-vs-host disease; the lesions occurred 3 months after the transfusion of peripheral blood stem cells from her HLA antigen-matched brother. However, there was no exacerbation of liver dysfunction, diarrhea, or bone marrow aplasia. The peculiar cutaneous lesions resPOnded well to topical phototherapy. Conclusion: These 2 patients shared a similarity in their lesions and circumstances under which the blood transfusion was performed to a debilitated patient from a close family member. We believe that focal epidermal necrosis observed in patients with this condition represents a variant of blood transfusion-associated lichenoid graft-vs-host disease that occurs uniquely in a skin-targeted fashion.

Original languageEnglish
Pages (from-to)743-746
Number of pages4
JournalArchives of Dermatology
Issue number6
Publication statusPublished - 2000 Jun


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