Chronic graft-vs-host disease: Common findings, questions to ask the patient
| Organs affected | Common findings | Questions to ask the patient |
|---|---|---|
| Skin | Poikiloderma: erythema Sclerotic features: thickened skin Lichen planus-like features: purple polygonal plaques Lichen sclerosus-like features: wrinkled, atrophic plaques Morphea-like features: small, red or purple patches with white center Dryness Pruritus Hypopigmentation or hyperpigmentation | Have you noticed any changes to your skin? |
| Mouth | Lichen planus-like changes: lacy white patches Xerostomia (dry mouth) Gingivitis: swelling, redness, bleeding, or pain of the gums Mouth ulcers Mucosal atrophy Mucosal pseudomembranes Mucoceles: painless mucus-filled cysts | Do you have dryness or sensitivity of your mouth? |
| Eyes | Dry, gritty, painful eyes Photophobia Periorbital hyperpigmentation | Have you noticed any changes in your eyes? |
| Liver | Jaundice Total bilirubin, alkaline phosphatase, and alanine aminotransferase levels > 2 times the upper limit of normal | |
| Gastrointestinal tract | Anorexia Nausea Vomiting Diarrhea Weight loss Dysphagia | Do you have any nausea, appetite changes, changes in bowel habits or appetite, or difficulty swallowing? |
| Lungs | Cough Dyspnea | Do you have a cough, wheezing, or shortness of breath? |
| Muscles and joints | Joint swelling Joint stiffness Muscle cramps Arthralgias Arthritis | Do you have any joint or muscle swelling, stiffness, or pain? |
| Genitalia | In women: vaginal dryness, pruritus, dyspareunia, lower urinary tract symptoms In men: burning, phimosis | Have you noticed any urinary or sexual symptoms? |
Based on information in reference 9.