Acute Graft versus Host Disease of the Skin
Grading
- Grading is mainly of historical interest as GVHD > Grade I has become rare because of better clinical regimens
- Grade I
- Vacuoular degeneration of basal and suprabasal epidermal cells
- (Not specific for GVHD)
- Grade II (considered minimal criteria for diagnosis of GVHD)
- Vacuolar degeneration
- Scattered apoptosis of individual keratinocytes
- Epidermotropic lymphocytic infiltrate
- Grade III
- Focal dermo-epidermal separation and cleft formation
- Grade IV
- Extensive necrosis of epidermis with denudation
- Interobserver agreement excellent with grade III and IV lesions
