{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:28:47Z","timestamp":1782300527478,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Complications of hematopoietic stem cell transplant (HSCT) include acute graft\u2010versus\u2010host disease (aGVHD). Severe cutaneous aGVHD can present with generalized erythroderma, desquamation, and bullae which can mimic toxic epidermal necrolysis (TEN). TEN occurs in response to a culprit medication. Transplant patients are often on many medications, making it difficult to distinguish between the two conditions. Given that TEN\u2010like aGVHD is rare, we describe a case series of pediatric patients and review the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multi\u2010institutional case series of children who developed TEN\u2010like aGVHD following bone marrow transplantation. Demographic, clinical, and treatment information was collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients were identified. Median age at transplantation was 8.5\u2009years (range 0.12\u201317\u2009years). Median time from transplant to first skin symptoms was 35\u2009days (range 6\u2013110\u2009days) and to first TEN\u2010like symptoms was 40\u2009days (range 16\u2013116\u2009days). 7\/10 had other organ GVHD involvement. All patients were on concurrent medications at time of first skin symptoms including immunosuppression for GVHD prophylaxis, infection prophylaxis or treatment, and pain medication. Treatments for TEN\u2010like aGVHD included immunosuppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observe that patients with &gt; or equal to 50% BSA involvement of their skin with TEN\u2010like aGVHD, extracutaneous GVHD, and lack of reepithelization tend to have poor outcomes. Given the rarity of this condition, multidisciplinary care of these patients is important for accurate and timely diagnosis and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.15069","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T06:49:45Z","timestamp":1655880585000},"page":"889-895","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Toxic epidermal necrolysis\u2010like acute graft\u2010versus\u2010host disease in pediatric bone marrow transplant patients: Case series and review of the literature"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9845-7361","authenticated-orcid":false,"given":"Johanna","family":"Sheu Song","sequence":"first","affiliation":[{"name":"Department of Dermatology University of California San Francisco School of Medicine  San Francisco California USA"},{"name":"Department of Dermatology Kaiser Permanente Northern California  Martinez California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6191-7486","authenticated-orcid":false,"given":"Jennifer T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Dermatology Program, Department of Dermatology, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria del Carmen","family":"Fraile Alonso","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8557-5986","authenticated-orcid":false,"given":"Richard J.","family":"Antaya","sequence":"additional","affiliation":[{"name":"Department of Dermatology Yale University School of Medicine  New Haven Connecticut 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-4278","authenticated-orcid":false,"given":"Sonal D.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California San Francisco School of Medicine  San Francisco California USA"},{"name":"Department of Dermatology, University Hospitals Cleveland Medical Center Case Western Reserve University School of Medicine  Cleveland Ohio 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