When to worry about persistent itching with graft-versus-host disease

Graft-versus-host disease can affect the skin after an allogeneic stem cell or bone marrow transplant. It may cause dryness, rash, tightness, colour change, scaling, or sensitivity, with itching that ranges from mild to intense. The skin may be involved alongside the mouth, eyes, gut, or liver.

A new rash or change in itching can have other causes, including medicines, allergy, infection, or dry skin. Report the location, speed of spread, pain, blisters, peeling, and any mouth, eye, bowel, or breathing symptoms.

Contact your transplant team about new or worsening itching, even if the skin changes seem small. Use only the creams, washes, and medicines they recommend. Fragrance-free moisturiser, gentle bathing, soft clothing, and cool compresses may reduce irritation.

Avoid scratching because broken skin can allow infection. Keep a note of new medicines, foods, products, and symptom changes so the team can assess possible triggers and decide whether treatment needs adjustment.

Seek urgent help for rapidly spreading rash, blistering, peeling, severe skin pain, fever, pus, or marked tenderness. Contact emergency services for facial or throat swelling, wheezing, trouble breathing, confusion, or collapse.

Diarrhoea, persistent vomiting, severe abdominal pain, yellowing of the skin or eyes, or inability to drink should be reported promptly because graft-versus-host disease can affect organs beyond the skin.

Could this itching be graft-versus-host disease, an infection, or a medicine reaction? Which skin products are safe after transplant? What symptoms outside the skin need an immediate call? How should I care for cracked or scratched areas?