Macrophages and Tumor Necrosis Factor a in Toxic Epidermal Necrolysis

1 May 1994

journal article
research article
Published by American Medical Association (AMA) in Archives of Dermatology

Vol. 130 (5) , 605-608
https://doi.org/10.1001/archderm.1994.01690050073012

Abstract

Background: We studied the immunopathologic characteristics of five cases of toxic epidermal necrolysis by using a large panel of antibodies. Observations: The pattern and amount of the inflammatory cell infiltrate varied according to the stage of the disease. The main constant feature was the prominent involvement of the monocyte-macrophage lineage, including factor XIIIa⁺HLA-DR⁺dendrocytes and CD68⁺Mac 387⁺macrophages, before and during the epidermal ne- crosis. The number of CD4⁺and CD8⁺lymphocytes was comparatively small. This was associated with a dense labeling of the epidermis for tumor necrosis factor a. Conclusions: Cells of the monocyte-macrophage lineage largely outnumber lymphocytes in the lesions of toxic epidermal necrolysis. Tumor necrosis factor a is likely a major cytokine that is responsible for necrosis. (Arch Dermatol. 1994;130:605-608)

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