Abstract: Liu Zehu, Cai Yongwei, Wang Song, Wang Mei, Shen Hong. Department of Dermatology, Third People′s Hospital of Hangzhou, Hangzhou 310009, China Corresponding author: Shen Hong, Email: shenhongsh@medmail.com.cn 【Abstract】 A 37-year-old male patient presented with persistent generalized itching erythema and papules for more than 1 month. The patient had received surgical treatment for type B3 thymoma in stage Ⅳ. Five months prior to the presentation, he developed myasthenia gravis. He also complained of chronic diarrhea for two years. Physical examination revealed white patches in the oral mucosa as well as scaly erythema of varying size on the face, trunk and extremities. Lamellar scales could be seen after scratching, while removal of scales could not result in the appearance of bleeding points. There was scaly hyperkeratotic erythema of palms and soles. Histopathological examination revealed psoriasis-like epidermal hyperplasia and parakeratosis with multiple dyskeratocytes, and some of the dyskeratocytes were surrounded by lymphocytes. There was a perivascular infiltration with a small number of lymphocytes. Immunohistochemical study showed positive staining for CD3, CD4 （dermis）, CD8 （epidermis） and CD45RO, but negative staining for CD20, CD68 and CD30. The patient was diagnosed as thymoma-associated graft-versus-host-like disease, myasthenia gravis and mucosal candidiasis. After treatment with tacrolimus and prednisone, the condition was gradually relieved.

Key words: Thymoma, Graft versus host disease, Skin manifestations, Pathology