Search

Gut dysbiosis is linked to mortality and the development of graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT), but the impact of cutaneous dysbiosis remains unexplored. We performed a pilot observational study and obtained retroauricular and forearm skin swabs from 12 adult patients prior to conditioning chemotherapy/radiation, and at 1-week, 1-month and 3-months after allogeneic HSCT, and performed shotgun metagenomic sequencing. The cutaneous microbiome among HSCT patients was enriched for gram-negative bacteria such as E coli and Pseudomonas, fungi, and viruses. Enrichment with bacteriophages and Polyomavirus sp, was observed among patients who died within 1-year, while we observed longitudinal stability of the cutaneous microbiome at the 3-month time point among those who survived beyond 1 year post-HSCT, although these may simply be a reflection of the overall medical status of the patients. There was no association with fungal abundance and any of the outcomes observed. The cutaneous microbiome may be a reservoir of pathobionts among allogeneic HSCT patients. Our findings suggest that cutaneous dysbiosis exists post-HSCT, but the ultimate implication of this to patient outcomes remains to be seen. Larger studies are required., (Copyright © 2025 American Society of Hematology.)

Cutaneous lichen planus (CLP) is a chronic autoimmune disease classically associated with severely pruritic, polygonal, violaceous, flat-topped papules and plaques. Subtypes such as hypertrophic and bullous lichen planus and lichen planus pigmentosus have been described. Treatment can be challenging, and prospective controlled studies are lacking. Corticosteroids remain the major options for topical and systemic treatment, although some non-steroidal options exist. Phototherapy, especially with narrow band ultraviolet B (NB-UVB), is effective, but caution must be taken because of the risk of keobnerization. Methotrexate and retinoids are an option for extensive disease, and are relatively well tolerated. Other treatments that have been investigated include sulfasalazine, low molecular weight heparin, griseofulvin, hydroxychloroquine, metronidazole and dapsone.