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A 28-year-old woman undergoes allogeneic bone marrow transplantation for acute leukemia. Three weeks later, she has marrow engraftment and her hemoglobin and WBC count are returning to normal. However, she has the appearance of a fine, scaling skin rash over her trunk and upper extremities. These findings are most consistent with which of the following complications?

A Reduced numbers of megakaryocytes

B Apoptosis of epidermal keratinocytes

C Dry gangrene

D Contact dermatitis

E Abrasions from a fight in the ICU

B?

(B) CORRECT. The rash is typical for graft versus host disease. The donor lymphocytes engraft and attack host tissues, causing apoptotic necrosis