Chronic GVHD often affects the skin, finger nails and toe nails, hair and sweat glands. Symptoms of skin GVHD include:
- dry, itchy rash
- a burning sensation when exposed to sun or heat
- a tightening or pulling sensation on the skin
- a change in skin color
- thickening of the skin that can restrict joint movement
- taut skin
- thin skin that tears easily
Skin GVHD may also cause:
- brittle or splitting fingernails and toenails
- hair loss or thinning hair
- changes in hair color or texture
- joint stiffness
- contractures (shortening or hardening of muscles and connective tissues)
- taut skin around the mouth, making it difficult to open the mouth
- an inability to sweat or handle heat for long periods of time, due to damaged sweat glands
- difficulty breathing, due to tight skin on the chest
- feeling full quickly because the abdomen is taut
- tightening of tissue under the skin (the fascia) which can look like cellulite
Corticosteroids or tacrolimus ointment applied directly on the skin may relieve the symptoms. If tight skin is restricting joint movement, physical therapy may help.
If skin GVHD is causing joint stiffness or contractures (shortening of muscle tissue), your doctor may recommend deep tissue massage or stretching exercises to improve your range of motion.
Extracorporeal photopheresis (ECP) is another treatment for skin GVHD. This procedure, which is not available at all transplant centers, removes some white blood cells from the patient, mixes them with psoralen, and exposes them to ultraviolet light. The cells are then re-infused into the patient. Find a hospital that offers ECP.
If you've ever had skin GVHD, it is important to protect your skin from exposure to the sun.
Skin GVHD can increase your risk of developing skin cancer.
When outside, wear a hat, long sleeves and pants. Use a strong sunscreen (SPF30 or higher) on any exposed skin. Keep in mind that the sun's rays can be just as damaging on a cool, cloudy day as they are on a hot, sunny day.
Companies like Sun Precautions® and Coolibar® offer sun protective clothing that can help shield your skin from the sun's harmful ultraviolet rays. The makers of RIT Dye make SunGuard™, a laundry detergent additive that will add sun block to your everyday clothing.