https://scholars.lib.ntu.edu.tw/handle/123456789/434907
標題: | Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features | 作者: | YUNG-TSU CHO Lin, Jheng-Wei Chen, Yi-Chun Chang, Chia-Ying Hsiao, Cheng-Hsiang Chung, Wen-Hung CHIA-YU CHU |
關鍵字: | fixed drug eruption;generalized bullous fixed drug eruption;granulysin;regulatory T cells;Stevens-Johnson syndrome;toxic epidermal necrolysis | 公開日期: | 三月-2014 | 卷: | 70 | 期: | 3 | 起(迄)頁: | 539 | 來源出版物: | Journal of the American Academy of Dermatology | 摘要: | Background Generalized bullous fixed drug eruption (GBFDE), a particular form of fixed drug eruption (FDE), is characterized by widespread blisters and erosions and can be confused with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Objective We sought to analyze specific features of GBFDE and differentiate it from SJS/TEN. Methods We retrospectively studied patients with GBFDE and SJS/TEN during a period of 10 years. GBFDE was defined as typical FDE lesions with blisters involving at least 10% body surface area on at least 3 of 6 different anatomic sites. Clinical presentations; histopathological features; immunohistochemical patterns of cluster-of- differentiation (CD)3, CD4, CD8, CD56, Fas, Fas ligand, granzyme B, perforin, granulysin, and forkhead box P3 (Foxp3); and serum granulysin levels were compared. Results Twenty-three cases of GBFDE were collected. Patients with GBFDE had shorter latent periods, less mucosal involvement, more eosinophil infiltration, and dermal melanophages. Lesional infiltrates in GBFDE had more dermal CD4+ cells including Foxp3+ regulatory T cells, fewer intraepidermal CD56+ cells, and fewer intraepidermal granulysin+ cells. The serum level of granulysin in GBFDE was also significantly lower than in SJS/TEN. Limitations The number of cases in this study is small. Conclusion GBFDE is a distinct disease distinguishable from SJS/TEN by particular features such as granulysin, CD56, and Foxp3 expressions. ? 2013 by the American Academy of Dermatology, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84894057183&doi=10.1016%2fj.jaad.2013.11.015&partnerID=40&md5=4ac8a21b05c89910ab5482c60bc605cb https://scholars.lib.ntu.edu.tw/handle/123456789/434907 |
ISSN: | 0190-9622 | DOI: | 10.1016/j.jaad.2013.11.015 | SDG/關鍵字: | fixed drug eruption; generalized bullous fixed drug eruption; granulysin; regulatory T cells; Stevens-Johnson syndrome; toxic epidermal necrolysis; Aged; Aged, 80 and over; Antigens, Differentiation, T-Lymphocyte; Biological Markers; Biopsy, Needle; Cohort Studies; Diagnosis, Differential; Drug Eruptions; Female; Forkhead Transcription Factors; Humans; Immunohistochemistry; Male; Middle Aged; Perforin; Prognosis; Retrospective Studies; Severity of Illness Index; Skin Diseases, Vesiculobullous; Stevens-Johnson Syndrome; Young Adult |
顯示於: | 醫學系 |
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