July-August 2014

 

Fig.1

Fig.2

Fig.3

Fig.4

 


History:  Patient is a 57 yo AAF with history of AML s/p matched unrelated donor SCT in June 2012. The stem cell transplant was complicated with gastrointestinal GVHD. On  May 2014 he presented with a diffuse, pruritic eruption on trunk and extremities of 3 weeks duration.

Past Medical History: AML s/p MUD SCT, history of acute gastrointestinal GVHD, HTN. He also had a hx of PE, osteoporosis, glaucoma and cataracts.

Allergies: Cefepime, Percocet, vicoden.

Social history: Retired. Non-smoker. Denies ethanol or illicit drugs.

Family History: Non-contributory

ROS: No dry mouth, no dysphagia, diarrhea, abdominal pain or dysuria. No dry eyes, ocular pain,

Medications: Amlodipine, budesonide ER 3mg bid, terparitide, furosemide 20mg qod, Bactrim DS, synthroid 25mcg  b.i.d., fexofenadine 180 mg qd, ciprofloaxin  0.3% ophthalmologic drops, dorozolamide Timolol ophthalmologic drops.

Physical exam: well appearing women in no acute distress. Extensive violaceous, polygonal papules and plaques with fine white scaling on the trunk and extremities (Figs.1,2,3). Several areas demonstrated lesions in a linear configuration suggesting koebnerization (4). Oral mucosa clear, no ocular injection and the nails were within normal limits.

 

 

 

Click here for the Diagnosis.