[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
January 1994

Abnormal T-Cell Response in Toxic Epidermal Necrolysis

Author Affiliations

Department of Dermatology Hospital Central University of San Luis Potosi School of Medicine Via Carranza 2405 San Luis Potosi, Mexico 78230

Chicago, Ill

Arch Dermatol. 1994;130(1):116. doi:10.1001/archderm.1994.01690010122026

The recently reported observations of Correia and Delgado1 add convincing support to other reports2,3 that an abnormal T-cell response is involved in the pathogenesis of toxic epidermal necrolysis (TEN). The observations that support the theory of immune system mediation of this disease include the following:

  1. The occurrence of TEN as a manifestation of severe acute graft-vs-host disease suggests a cell-mediated immune pathogenesis.

  2. The dermal infiltrate in TEN is composed mainly of activated T lymphocytes with a predominantly cytotoxic phenotype.

  3. Patients who suffer a second bout of TEN caused by the same drug undergo a shorter incubation period and have more severe disease.

  4. Keratinocytes express HLA-DR and ICAM-14 molecules; normally, they do not.

  5. Recently, in the early lesions of TEN, perforin mRNA has been found in the granules of CD8 cytotoxic T cells.5

In view of these facts, it has been unfortunate that in the

First Page Preview View Large
First page PDF preview
First page PDF preview