Jamil Shahid.
Graft versus host disease (GVHD).
J Pak Assoc Derma Nov ;8(1):2-5.

GVH disease evolves in two distinct clinical and pathological phases - acute and chronic. The acute phase which induces skin symptoms characterized by a specific lymphocyte target cell reaction has been termed `satellite cell necrosis`. Donor lymphocytes migrate to the epidermis inducing vacuolization, spongiosis, basal cell necrosis and melanocyte degeneration (changes not dissimilar to Lichen planus). As the immunological attack persists, the spectrum of disease changes into the chronic form. Thus both cellular and humoral involvement forms the basis of a complex immunopathogenetic phenomenon in GVH disease, partly mediated by lymphocyte cytotoxicity against keratinocytes, melanocytes and Langerhans cells.

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