Graft-versus-host disease (GVHD) is a multisystemic disorder that affects 30-80% of patients who undergo allogeneic hematopoietic stem cell transplantation 10-15% of GVHD patients develop sclerotic features affecting the skin or deeper tissues, leading to functional limitations and poor quality of life. There is limited literature regarding the indications and efficacy of specific rehabilitative interventions in sclerotic GVHD. In this paper, we summarize the current evidence supporting rehabilitation intervention in sclerotic GVHD and offer our approach to the multidisciplinary management of this disease. In addition, we review techniques that have been employed in other sclerotic skin diseases (e.g. iontophoresis, extracorporeal shock waves, botulinum toxin A, adipose derived stromal vascular fraction), but that require further validation in the sclerotic GVHD setting. Ultimately, optimal care for this complex disease requires a multi-disciplinary approach that includes a rehabilitation and adaptive program tailored to each patient needs.

中文翻译：

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皮肤筋膜硬化性移植物抗宿主病患者多学科管理中的康复干预

移植物抗宿主病 (GVHD) 是一种多系统疾病，影响 30-80% 接受异基因造血干细胞移植的患者 10-15% 的 GVHD 患者出现影响皮肤或深层组织的硬化特征，导致功能受限和生活质量差。关于硬化性 GVHD 特定康复干预的适应症和疗效的文献有限。在本文中，我们总结了目前支持硬化性 GVHD 康复干预的证据，并提供了我们对该疾病的多学科管理的方法。此外，我们回顾了已用于其他硬化性皮肤病的技术（例如离子电渗疗法、体外冲击波、肉毒杆菌毒素 A、脂肪来源的基质血管成分），但这需要在硬化 GVHD 设置中进一步验证。最终，对这种复杂疾病的最佳护理需要多学科方法，包括针对每位患者需求量身定制的康复和适应性计划。