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Gary L. Peck, MD; Geoffrey P. Herzig, MD; Peter M. Elias, MD

Arch Dermatol. 1972;105(4):561-569.

Abstract
Toxic epidermal necrolysis (TEN) occurred in a patient with graft-vs-host reaction (GVH). Certain factors link TEN and GVH in this patient. A 22-year-old man with acute lymphocytic leukemia, treated with allogeneic bone marrow transplantation, developed GVH as manifested by diarrhea, hepatitis, lymphopenia, and a progressive cutaneous eruption. The initial morbilliform eruption later became intensely erythematous, and massive desquamation of large sheets of epidermis, typical of TEN, ensued. Cutaneous histopathology early in the clinical course showed changes of GVH. Later biopsies were also consistent with the diagnosis of TEN. Experimental models of TEN accompanying GVH and a discussion of pathogenesis are included. Graft-vs-host reaction should be added to Lyell's group of systemic diseases associated with TEN.

Author Affiliations
Bethesda, Md

From the Dermatology Branch (Drs. Peck and Elias) and Medicine Branch (Dr. Herzig), National Cancer Institute, National Institutes of Health, Bethesda, Md.

Footnotes
Accepted for publication March 31, 1971.

This manuscript was awarded first prize in the 1971 North American Clinical Dermatological Society Memorial Essay Contest. It was read before the 12th annual meeting of the North American Clinical Dermatological Society, Cartagena, Colombia, April 20, 1971.

Reprint requests to Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md 20014 (Dr. Peck).

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