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The Challenge to Dermatologists

Arch Dermatol. 2001;137:75-76.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

ANY DERMATOLOGIST who has been consulted to see a patient who has had a bone marrow transplant (BMT) and then developed a new rash recognizes the difficulty in distinguishing a drug eruption from graft-vs host-disease (GVHD). Over the coming years this is going to be a more, not less, frequent source of frustration for several reasons. Bone marrow transplantation has grown by over 10-fold between 1985 and 1995, and it continues to grow by 10% to 20% annually to more than 15 000 procedures per year worldwide.¹ This is not surprising because BMT is the only hope for survival for many patients with hematologic malignant neoplasms, and improving technology and survival rates have extended the clinical indications considerably. A distinct trend though is that owing to new technologies for suppressing acute GVHD and a lack of perfectly matched donors, more BMT recipients are receiving less closely matched transplants. In combination, these . . . [Full Text of this Article]

CLINICAL DIAGNOSIS IS TRICKY


HISTOPATHOLOGIC DIAGNOSIS IS IMPOSSIBLE

DO EOSINOPHILS MEAN DRUG OVER GVHD? (NO!)

IS THERE ANY ROLE FOR BIOPSY FOR A POSSIBLE GVHD RASH?

If A DEFINITIVE DIAGNOSIS IS IMPOSSIBLE, WHAT DOES ONE DO?

A DIFFERENT MINDSET FOR THE DERMATOLOGIST

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