What is chronic GVHD of the skin?

Sclerotic GVHD is a more severe type of skin GVHD. “Sclerotic” means thickened or hardened. It can affect not only the skin but also deeper tissues, including the fascia (the layer between skin and muscle).

You may notice:

• Tight, thick or “woody” skin.
• Decreased flexibility or joint stiffness, especially in the wrists, shoulders, elbows or ankles.
• Swelling or tightness in the lower belly or back, which may make breathing more difficult or reduce your appetite.
• Skin sores, particularly on the legs, that are slow to heal.

This type of GVHD may limit movement and affect daily activities, so early detection and treatment are important.

• Dry, itchy or scaly skin
• Redness, rash or areas that feel like a sunburn
• Skin that feels tight, thickened or hard (like wood)
• Pulling or tugging sensations under the skin
• Color changes (pink, red, brown, purple or white)
• Blisters, bumps or sores
• Trouble moving joints or areas near tight skin

Chronic skin GVHD may cause:

• Thinning or thickening of the skin
• Hard or “woody” areas
• Rashes, bumps or scales
• Discoloration or patches that change color over time
• Blisters or sores that heal slowly

To learn more about how GVHD can affect different parts of your body, view our full list of GVHD symptoms.

• Apply moisturizer right after bathing to lock in moisture. Choose ointments or creams instead of lotions.
• Avoid sun exposure. Wear protective clothing and use broad-spectrum sunscreen daily.
• Avoid long baths or hot showers, which can dry out your skin.
• Gently stretch or move tight areas to help maintain flexibility. Ask your doctor about physical therapy.
• Keep any open sores clean and dry. Ask your care team if bandages or topical medicines can help.
• Avoid sitting for long periods or crossing your legs, which can reduce blood flow.

• Tell your care team about any new or worsening skin changes.
• Report tightness, decreased flexibility or skin that feels hot or painful.
• See your doctor regularly to check for skin cancer or other long-term changes.
• Call your doctor if your joints become harder to move or if you notice new bumps or sores that do not heal.

To diagnose chronic GVHD of the skin, your doctor will do a physical exam. They may gently stretch or press on your skin to check for thickening, tightness or color changes. In some cases, a small skin biopsy may be needed to confirm the diagnosis.

If GVHD is found, treatment may include:

• Prescription immunosuppressants, taken as pills or injections, to reduce inflammation and help slow or prevent further thickening of the skin and tissues.
• Topical treatments like corticosteroid creams or ointments, or immune-suppressing medicines such as tacrolimus or pimecrolimus. These may help relieve rash and itching.
• Photopheresis (ECP), a treatment where your blood is removed, treated with light and returned to your body.
• Antihistamines or anti-itch creams to help reduce discomfort from itching.