Priscila Giavedoni, Carmen Martinez, Sebastian Podlipnik, María Suárez-Lleidó, Ignasi Martí-Martí, Daniel Morgado-Carrasco, Montserrat Rovira, Francesc Fernández-Avilés, Gonzalo Gutiérrez, Laura Rosiñol, Joan Cid, Miquel Lozano, José Manuel Mascaró, Jr.
DOI: 10.2340/00015555-3747

Sclerodermoid chronic graft-versus-host disease (scGVHD) is a severe complication of allogeneic haema­- topoietic stem cell transplantation. The aim of this study was to investigate the usefulness of high-frequency ultrasound of the skin in assessing the inflammatory patterns and prognosis of patients with scGVHD. A prospective study was carried out with patients who developed scGVHD in the period June 2016 to April 2018. Clinical and ultrasound examinations were performed on the first visit and at 6-month follow-up. A total of 24 patients were included in the study. A 6-month follow-up high-frequency ultrasound of the skin was performed on 20 of the 24 patients. Abnormal B-mode findings in high-frequency ultrasound of the skin consisted of hypoechogenic dermis, hypoechogenicity of septa and hyperechogenicity of lobules in hypodermis. No differences were observed in these basal parameters between treatment progressive/non-responding and inactive/responding scGVHD groups of patients. Basal Doppler showing increased vascular flow with a systolic peak ≥10 cm/s and a vascular resistance index ≥ 0.70 was observed only in those patients who developed progressive/non-responding scGVHD (62.5% vs 0% p = 0.006). In conclusion, Doppler ultrasound is a useful tool to assess the inflammatory activity and outcome of scGVHD. These findings could enhance patient management and help to guide treatment decisions.

Graft-versus-host disease is one of the most serious complications of haematopoietic stem cell transplantation. However, treatment with immunosuppressants to reduce inflammation increases the risk of recurrence of the neoplasm that necessitated the stem cell transplantation. Hence, it is extremely important in these patients to determine whether graft-versus-host disease is active, in order to make appropriate treatment decisions. High-frequency skin ultrasound is an imaging technique that is used increasingly in dermatology and can be useful in diagnosing this disease. Skin inflammation can be quantified using the colour Doppler mode. Clinical and ultrasound monitoring enable objective assessment of these patients.