acute graft versus host disease by dr. qutaiba abdulah
TRANSCRIPT
![Page 1: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/1.jpg)
2.5 years old 21% BSAB
Involving back, upper buttock rt-arm both loin area, Scald injury hot milk
![Page 2: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/2.jpg)
![Page 3: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/3.jpg)
![Page 4: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/4.jpg)
![Page 5: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/5.jpg)
All vital signs & investigations done with ideal
results
![Page 6: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/6.jpg)
She is doing very well with this large healthy burnd wound
![Page 7: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/7.jpg)
![Page 8: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/8.jpg)
![Page 9: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/9.jpg)
![Page 10: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/10.jpg)
Slow healing
but looks
healthyPt doing
good
![Page 11: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/11.jpg)
![Page 12: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/12.jpg)
SYSTEMIC SKIN ERRUPTION ARE SET TO START
![Page 13: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/13.jpg)
SCALP LESIONSCALP LESION ++CRUSTATIONCRUSTATION
EPIDERMALEXFOLATIONOF EAR SKIN & CHEEKS
![Page 14: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/14.jpg)
Human GVHD occur after allogenic Human GVHD occur after allogenic stem cell transplantationstem cell transplantation,,
Acute GVHD Acute GVHD describes a distinctive describes a distinctive syndrome of Dermatitis,Hepatits,& syndrome of Dermatitis,Hepatits,& Enteritis developing within 100 days Enteritis developing within 100 days of allogenic hematopoietic cell of allogenic hematopoietic cell transplantationtransplantation
Chronic GVHD Chronic GVHD describes a more describes a more diverse syndrome developing after diverse syndrome developing after day 100day 100
![Page 15: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/15.jpg)
Who agree with EXCISION – RE AUTO GRAFTING
Who agree with SYSTIMIC STEROID TREATMENT IF STARTED Auto -SKIN GRAFTING ARE CONTRAINDICATED
![Page 16: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/16.jpg)
Take biopsy from lesion & from unburned skin a maccule 2 cm distant area from the wound.
The allograft are excised ,dressing by sofratule mesh gauze and povidon iodin impregnated gauze bandaging.
![Page 17: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/17.jpg)
![Page 18: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/18.jpg)
DESQUAMATION & BULLAE
![Page 19: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/19.jpg)
![Page 20: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/20.jpg)
![Page 21: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/21.jpg)
![Page 22: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/22.jpg)
![Page 23: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/23.jpg)
![Page 24: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/24.jpg)
![Page 25: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/25.jpg)
Clear face no skin lesion dramatic response
![Page 26: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/26.jpg)
![Page 27: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/27.jpg)
![Page 28: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/28.jpg)
Before Before operationoperation
4 days later After After operationoperation
![Page 29: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/29.jpg)
Separation of epidermis from dermis (bullae like) (x4) biopsy 2 cm distant from wound {at un burned skin}
![Page 30: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/30.jpg)
Irregularity in rete ridges (x4)
![Page 31: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/31.jpg)
Separation of dermis from dermis with upper dermal inflammation (x10)
)
![Page 32: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/32.jpg)
Upper dermal lymphocytic infiltration (x40) path gnomonic Upper dermal lymphocytic infiltration (x40) path gnomonic sign of AGVHD in the Skin sign of AGVHD in the Skin
![Page 33: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/33.jpg)
![Page 34: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/34.jpg)
Auto split thickness Skin-Graft done
![Page 35: Acute graft versus host disease by dr. qutaiba abdulah](https://reader034.vdocuments.site/reader034/viewer/2022052316/559431991a28abca7e8b458a/html5/thumbnails/35.jpg)
1111 55 20132013
Thank you Dr.qutaiba abdulah aldori
Azadi Hospital \kerkuk\ Iraq
1818 66 20132013