GVHD is a common problem after bone marrow transplantation and can be divided into an acute and a chronic phase. In the chronic phase, an early lichenoid stage and a late sclerotic stage can be distinguished.

This patient was a recipient of bone marrow transplantation. She had developed these cutaneous lesions after about 18 months following bone marrow transplantation. Usually the cutaneous lesions of GVHD are generalized, but in rare instances as this patient it may be localized.

Irregular pigmentations, sclerotic areas, a quite compatible histopathology and of course the history were all in favor of the diagnosis of chronic GVHD for this case.

Omid Zargari, MD

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