We have consistently noticed in our clinical practice eczematous dermatitis (EcD) without other pathologic findings of graft-versus-host disease (GVHD) in recipients of unrelated cord blood transplantation (CBT). We hypothesized that the incidence of EcD was higher in CBT compared to other donor types.
To compare the frequency, clinical course, and response to therapy of EcD among CBT and non-CBT recipients.
We conducted a retrospective study of 720 consecutive adult recipients of allogeneic hematopoietic cell transplants from 2010 to 2016 from any donor type and with follow-up for at least one year after transplantation. After using a keyword-based automated scanning to identify “eczema”, “dermatitis” or “spongiosis” terms in medical records, we retrieved 217 cases for manual record review.
We identified 23 EcD cases (12 in CBT recipients and 11 in patients with other types of donors) with a median onset at 8 months after transplantation. The two-year cumulative incdence of EcD was 20% (95% confidence interval [CI] 11.2%, 31.5%) after CBT and 1.7% (95% CI, 0.9%, 2.9%) with other types of donors (p 6 months, in 6/58 vs. 1/661, p<.0001). In both groups, EcD responded to topic therapy, and only a few cases required systemic therapy.
EcD is a relatively frequent skin condition among recipients of unrelated CBT. Irrespective of donor type, most cases of EcD can be successfully managed with only topical therapy. These findings will help providers recognize EcD, avoid potentially harmful systemic therapy, and better counsel transplant recipients.

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