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Possible Pathogenic Mechanism Induced by CD8-Positive T Cells

Hiroko Miyauchi, MD; Hiroshi Hosokawa, MD; Tamiyo Akaeda, MD; Hitoki Iba, MD; Yasuo Asada, MD

Arch Dermatol. 1991;127(6):851-855.

Abstract
• A patient with bromisovalum-induced toxic epidermal necrolysis showed pronounced delayed hypersensitivity to bromisovalum by patch testing. Biopsy specimens from the cutaneous lesion and the site of the positive patch test reaction were analyzed and compared immunohistologically. The findings were similar: most of the mononuclear cells disposed along the dermoepidermal junction and migrating into the epidermis were CD8-positive lymphocytes, whereas the dermal inflammatory infiltrates were composed predominantly of CD4-positive lymphocytes. This case showed the potential usefulness of patch testing in evaluating cases of toxic epidermal necrolysis. We believe that delayed hypersensitivity plays a crucial role in the development of druginduced toxic epidermal necrolysis. Furthermore, potential effector cells with phenotypic characteristics of CD8-positive lymphocytes (suppressor/cytotoxic T cells) seem to represent important mediators of the epidermal damage of the cutaneous lesion in our case.

(Arch Dermatol. 1991;127:851-855)

Author Affiliations
From the Department of Dermatology, Kansai Medical University, Osaka, Japan.

Footnotes
Accepted for publication November 6, 1990.

Reprint requests to Department of Dermatology, Kansai Medical University, 1 Fumizono-cho, Moriguchi, 570 Osaka, Japan (Dr Miyauchi).

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