Graft-versus-host disease physical examination
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The physical exam for GvHD focuses on the organ involved, including the skin, liver, and GI tract. Rash and hyperpigmentation are the most common skin exam findings. Jaundice and abdominal tenderness are the most common liver and GI tract exam findings. The lungs or eyes can also be involved in more rare cases. A detailed physical exam is important for an accurate assessment of GvHD diagnosis and for assessment of the severity of the disease.
- Maculopapular rash
- Lichen planus-like lesions
- Scleral icterus
- Leg swelling
- Tenderness in the right upper quadrant of the abdomen
- Bleeding from coagulopathy
- Signs of cholestatic hepatitis
Other physical exam findings are based on the particular organ involved.
- Eye: If there is evidence of ocular GvHD, a full ophthalmologic exam should be done. Ocular GvHD can occur in up to 60% of patients, but the clinical exam findings and severity of disease is variable from patient to patient. Findings in ocular GvHD include:
- Ocular perforation
- Conjunctival damage
- Keratopathy (corneal damage),
- Dry eyes
- Milphosis (Loss of eyelashes)
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