Graft-versus-host-disease (GVHD) is a potentially fatal condition that can occur after solid organ transplantation (SOT) and often presents with a skin rash. Upon conducting a systematic literature review of SOT GVHD, investigators recommend that dermatologists have a low threshold to consider and pursue this diagnosis in the setting of post-SOT skin eruption.

The review included 61 articles, representing 115 patients and 126 transplanted organs. Key points include:

• The most commonly transplanted organ was the liver (n=81).
• Among total patients, 101 (87.8%) developed skin involvement.
• The eruption appeared an average of 48.3 days (range, 3-243 days) posttransplant and was pruritic in 5 of 101 (4.9%) cases.
• The eruption was described as morbilliform in 2 patients (1.9%), confluent in 6 (5.9%), and desquamative in 4 (3.9%) cases.
• The mortality rate was 72.2%.
• Relative time of death was reported in 23 patients who died during the follow-up period; they died an average of 99.2 days (range, 22-270 days) posttransplant, or 50.9 days after the appearance of dermatologic symptoms.
• Frequent causes of death were sepsis and multiorgan failure.