Nonpigmenting fixed drug eruption as a possible abortive variant of toxic epidermal necrolysis: immunohistochemical and serum cytokine analyses
Nonpigmenting fixed drug eruption as a possible abortive variant of toxic epidermal necrolysis: immunohistochemical and serum cytokine analyses
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DOI：
10.1111/j.1365-2230.2009.03622.x
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发表时间：
2010-07-01
影响因子：
4.1
通讯作者：
Shiohara, T.
中科院分区：
文献类型：
--
作者：
Mizukawa, Y.;Shiohara, T.
非色素性固定性药疹（NPFDE）在临床上最初表现与Stevens-Johnson综合征（SJS）或中毒性表皮坏死松解症（TEN）难以区分。NPFDE中不存在表皮变化的传统范例与SJS/TEN的临床相似性不容易调和。因此，我们研究了NPFDE是否与色素性FDE（PFDE）或SJS/TEN在发病机制上不同，以及哪些因素导致缺乏色素沉着。与PFDE相比，激发前NPFDE病变的特征是大量的CD 8+表皮内T细胞与少量的黑素细胞相关。在临床激发后观察到非常高水平的血清白细胞介素（IL）-10。我们的结论是NPFDE是一种临床综合征与异质性组织学表达。表皮受累的NPFDE可能是SJS/TEN的一种流产形式，IL-10可阻止其进展为TEN。
Nonpigmenting fixed drug eruption (NPFDE) is clinically indistinguishable from Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) in its initial presentation. The traditional paradigm that epidermal changes are absent in NPFDE cannot be easily reconciled with the clinical resemblance to SJS/TEN. We therefore investigated whether NPFDE is pathogenetically different from pigmented FDE (PFDE) or SJS/TEN and which factors are responsible for the lack of hyperpigmentation. NPFDE lesions before challenge were characterized by larger numbers of CD8+ intraepidermal T cells associated with a paucity of melanocytes, compared with those in PFDE. Very high levels of serum interleukin (IL)-10 were noted after clinical challenge. We conclude that NPFDE is a clinical syndrome with heterogeneous histological expression. NPFDE with epidermal involvement may be an abortive form of SJS/TEN, in which progression to TEN can be prevented by IL-10.