Toxic epidermal necrolysis: Part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis

Robert A. Schwartz, Patrick H. McDonough, Brian W. Lee

Research output: Contribution to journalReview articlepeer-review

187 Scopus citations

Abstract

Toxic epidermal necrolysis is a life-threatening, typically drug-induced mucocutaneous disease. It is clinically characterized as a widespread sloughing of the skin and mucosa, including both external and internal surfaces. Histologically, the denuded areas show full thickness epidermal necrosis. The pathogenic mechanism involves antigenic moiety/metabolite, peptide-induced T cell activation, leading to keratinocyte apoptosis through soluble Fas ligand, perforin/granzyme B, tumor necrosis factor-alfa, and nitric oxide. Recent studies have implicated granulysin in toxic epidermal necrolysis apoptosis and have suggested that it may be the pivotal mediator of keratinocyte death.

Original languageEnglish (US)
Pages (from-to)173.e1-173.e13
JournalJournal of the American Academy of Dermatology
Volume69
Issue number2
DOIs
StatePublished - Aug 2013

All Science Journal Classification (ASJC) codes

  • Dermatology

Keywords

  • Stevens-Johnson syndrome
  • apoptosis
  • drug eruption
  • erythema multiforme
  • granulysin
  • toxic epidermal necrolysis

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