LAUSR

cGVHD may occur, and it is important for dermatologists to recognize them. A Koebner isomorphic pattern in sclerotic-type cutaneous cGVHD has been reported in adults, mostly involving pressure areas, intravenous or subcutaneous injection sites, dermatomal sites of previous varicella-zoster virus infection, or after radiotherapy or phototherapy. It is known that type I interferon is a central factor in the inflammatory and fibrotic autoimmune process in systemic sclerosis. Martires et al. demonstrated a similarly significant role in lichen planus-like cGVHD by immunohistochemical studies. To the best of our knowledge, no similar cases have been reported in childhood, although cutaneous aGVHD after sun and narrow-band ultraviolet B exposure have been described in two children with cGVHD. The authors suggest that this phototoxic-induced relapse represents an isomorphic reaction. Moreover, Cohen and Hymes reported a linear lichenoid cGVHD in a 17-year-old girl after receiving allogeneic bone marrow transplantation for aplastic anemia. However, in this case the lesions appeared on previously normal skin, representing a dermatomal lichenoid GVHD. Finally, only one case of GVHD in striae distensae has been published. The authors report superficial lichenoid dermatitis compatible with cGVHD in a 23-year-old patient. In conclusion, we report a unique case of cutaneous aGVHD showing a Koebner isomorphic pattern over striae distensae in a child, highlighting the importance to recognize and accurately diagnose cutaneous GVHD in all its atypical manifestations.