Graft Versus Host Disease: Atypical Presentations & Nail Disease

The presentation by Dr. Rana, a dermatologist at Stanford and director of the nail clinic, focuses on graft versus host disease (GVHD) and its effects, particularly on nail health. She discusses the varied manifestations of chronic GVHD, including presentations that resemble conditions like lichen planus and psoriasis. Through illustrative clinical cases, Dr. Rana highlights the challenges in diagnosing and treating GVHD, emphasizing the crucial role of dermatologists in these scenarios. She notes that nail disease often goes unrecognized in traditional GVHD assessments, despite potentially affecting up to 50% of patients. The talk also covers common presentations of nail GVHD, the implications of autoimmune conditions in transplant patients, and treatment strategies, including intralesional steroid injections. Dr. Rana stresses the importance of monitoring for secondary infections and malignancies, given the immune suppression experienced by these patients. Ultimately, she advocates for the consideration of nail health in GVHD management due to its significant impact on patient quality of life.