今日の臨床サポート

固定薬疹

関連論文:
img  1:  Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features.
 
著者: Yung-Tsu Cho, Jheng-Wei Lin, Yi-Chun Chen, Chia-Ying Chang, Cheng-Hsiang Hsiao, Wen-Hung Chung, Chia-Yu Chu
雑誌名: J Am Acad Dermatol. 2014 Mar;70(3):539-48. doi: 10.1016/j.jaad.2013.11.015. Epub 2014 Jan 2.
Abstract/Text 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.

Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
PMID 24388722  J Am Acad Dermatol. 2014 Mar;70(3):539-48. doi: 10.1016/j.jaad.2013.11.015. Epub 2014 Jan 2.
戻る

さらなるご利用にはご登録が必要です。

こちらよりご契約または優待日間無料トライアルお申込みをお願いします。

(※トライアルご登録は1名様につき、一度となります)


ご契約の場合はご招待された方だけのご優待特典があります。

以下の優待コードを入力いただくと、

契約期間が通常12ヵ月のところ、14ヵ月ご利用いただけます。

優待コード: (利用期限:まで)

ご契約はこちらから