To the Editor.—
We have read with great interest the immunohistochemical study by Miyauchi et al1 demonstrating a predominance of CD8+ T lymphocytes in the epidermis of lesional skin in patients with toxic epidermal necrolysis. Using immunohistological techniques, we have analyzed the lesional T-cell infiltrate in skin biopsy specimens from four individuals undergoing bullous drug reactions. Consistent with the data reported by Miyauchi et al, we have found that there is a predominance of CD8+ T cells in the epidermis in these reactions.Additionally, six epidermal and dermal T-cell lines were derived from two patients with ampicillin-induced bullous exanthemas and from a patient allergic to penicillin who had a positive patch test reaction to penicilloyl and cephalothin. These cultured lesional T cells, which were expanded in vitro with interleukin-2, were found to be CD3+ (98% to 100%), CD4+ (0% to 14%), CD8+ (76% to 100%), and HLA-DR+ (78% to
Hertl M, Merk HF, Bohlen H. T-cell Subsets in Drug-Induced Toxic Epidermal Necrolysis. Arch Dermatol. 1992;128(2):272. doi:10.1001/archderm.1992.01680120148026
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