GVH – low magnification
GVH
- Epidermal atrophy
- Minimal inflammation – very little lymphocytic infiltrate
Predominant involvement of hair follicles (folliculotropism) and eccrine glands is characteristic of acute graft-versus-host disease (GVHD)
GVH
LEGEND
Depending on the severity of graft-versus-host disease, extensive keratinocyte necrosis may progress to full-thickness epidermal necrosis with blister formation. Differentiating GVHD from Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) may therefore be histologically impossible.
- Vacuolar interface dermatitis
Apoptotic keratinocytes
Area of epidermal detachment
Pigment incontinence indicating interface involvement
GVH
- Cytoid bodies (apoptotic keratinocytes)
There is a mismatch between the abundance of apoptotic keratinocytes and the minimal lymphocytic infiltrate, which is typical of graft-versus-host disease (many apoptotic keratinocytes despite few lymphocytes present).
