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Alopecia may be permanent in one in four pediatric HSCT patients.

AT WCPD 2017

CHICAGO -- Late dermatologic manifestations in children who have received hematopoietic stem cell transplants may be more common than previously thought, according to results of a prospective study.

Johanna Song, MD, a resident dermatologist at Harvard University, Boston, and her collaborators reported that in their study 25% of patients had permanent alopecia and 16% had psoriasis, noting that late nonmalignant skin effects of hematopoietic stem cell transplantation (HSCT) have been studied primarily retrospectively, and in adults. Vitiligo and nail changes were also seen.

In a poster presentation at the World Congress of Dermatology, they noted that these figures are higher than the previously reported pediatric rates of 1.7% for vitiligo and 15.6% for permanent alopecia. "Early recognition of these late effects can facilitate prompt and appropriate treatment, if desired," they said.

The single-center cohort study tracked 85 pediatric patients (median age, 13.8 years) over an 18-month period and included patients who were at least 1 year post allogeneic HSCT and had not relapsed. Participants were a median of 3.6 years post transplant when enrolled.

Chronic graft versus host disease (GVHD), skin chronic GVHD, a HSCT regimen that included busulfan conditioning, and a family history of early male-pattern alopecia were all significantly associated with postHSCT permanent alopecia (P less than .05 for all).

Psoriasis was seen on the scalp in 11 of the 14 patients with psoriasis (79%), and involved the face in 5 patients (36%); 1 patient had psoriasis elsewhere on the body. These late effects "can significantly impact patients' quality of life," according to the authors, who called for larger studies that follow pediatric HSCT patients longitudinally, beginning before the transplant--and for more investigation into the pathogenesis of specific late effects.

Dr. Song reported no relevant conflicts of interest. On Twitter @karioakes

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Article Details
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Author:Oakes, Kari
Publication:Dermatology News
Article Type:Clinical report
Date:Dec 1, 2017
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