Advancing Knowledge of Acute Cutaneous Graft-Versus-Host Disease Wound Care. A Case Study

BACKGROUND: Acute cutaneous graft-versus-host disease (GvHD) is a frequent complication of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It requires multidisciplinary systemic and topical management. However, no well-established recommendations regarding wound management have been established. This case study describes our experience caring for the wound of a patient with acute myeloid leukemia who developed a grade IV stage 4 acute cutaneous GvHD. CASE: Mr T was a 64-year-old male diagnosed with acute myeloid leukemia with myelodysplasia-related changes. Seventyfive days after receiving an allogeneic human leukocyte antigen-HSCT, he developed wounds on his upper and lower limbs, part of his chest, torso, and sacrum. Four lines of therapy (systemic steroids, tacrolimus together with extracorporeal photopheresis, etanercept, and ruxolitinib) integrated with wound care using advanced dressings of soft silicone layers led to the resolution of his wounds on day 109. CONCLUSION: Our case study provides further evidence for the management of cutaneous GvHD. Further studies are required to assess the effectiveness of silicone layer dressings for managing allogeneic HSCT recipients with cutaneous GvHD on a large scale to provide definitive recommendations for their use. KEY WORDS: Acute cutaneous graft-versus-host disease, Allogeneic hematopoietic stem cell transplantation, Nursing, Soft silicone layer, Wound care.