Skip to main content

Table 2 Histological grading system for acute and chronic cutaneous graft versus host disease

From: Clinical versus histological grading in the assessment of cutaneous graft versus host disease

Histological grading of acute GvHDa
Grade Morphological criteria
0 Normal skin or epidermal changes due to other causes than GvHD
1 Vacuolar alteration of junction between epidermis and dermis
2 Grade 1 with dyskeratotic cells within the epidermis and/or hair follicle, infiltrate of lymphocytes within the dermis
3 Grade 2 with fusion of vacuoles to form clefts and microvesicles
4 Separation of epidermis from dermis
Histological grading chronic GvHD (proposed criteria focusing on sclerotic features only)b
Grade Criteria
Limited Sclerosis within the superficial dermis, including coarsening of the fibers
Extensive Sclerosis extending into the deep dermis or very dense sclerosis in any layer of the skin
  1. aAccording to Horn’s adapted criteria from Lerner [7]
  2. bIn histological grading, the lichenoid variant of chronic GvHD was graded according to the components in acute GvHD