Lichenoid sialadenitis in chronic graft versus host disease

Dermatol Online J. 2020 Dec 15;26(12):13030/qt7wp6t39z.

Abstract

Chronic graft versus host disease (cGVHD) remains the principal long-term life-threatening complication in hematopoietic stem cell transplant recipients. We present a case of lichenoid sialadenitis in a 23-year-old-man with systemic cGVHD. The histological examination showed a lymphocytic inflammatory infiltrate adjacent to the salivary gland duct, similar to the histological aspects described in the typical manifestations of oral lichen planus and lichen planopilaris. This consists of a band-like inflammatory infiltrate not only targeting the cutaneous epithelium but also adnexal structures, such as hair follicles and salivary gland ducts. It is well described that the oral lesions in cGVHD share most of morphological and clinical manifestations with those described in oral lichen planus. The mechanisms of lichenoid salivary gland ducts destruction might be similar, although xerostomy appears to be specific to cGVHD, which may represent a clinical sign of massive salivary gland impairment related to ductal lichenoid destruction in patients with cGVHD.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Aplastic / therapy
  • Chronic Disease
  • Graft vs Host Disease / complications
  • Graft vs Host Disease / pathology*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Lichen Planus, Oral / etiology*
  • Lichen Planus, Oral / pathology
  • Male
  • Salivary Glands / pathology
  • Severity of Illness Index
  • Sialadenitis / etiology*
  • Sialadenitis / pathology
  • Young Adult