Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions
Diagnosis of severe cutaneous adverse drug reactions should involve immunohistopathological examination, which gives insight into the pathomechanisms of these disorders. The characteristic histological findings of erythema multiforme (EM), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolys...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2017/6928363 |
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| author | Mari Orime |
| author_facet | Mari Orime |
| author_sort | Mari Orime |
| collection | DOAJ |
| description | Diagnosis of severe cutaneous adverse drug reactions should involve immunohistopathological examination, which gives insight into the pathomechanisms of these disorders. The characteristic histological findings of erythema multiforme (EM), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) provide conclusive evidence demonstrating that SJS/TEN can be distinguished from EM. Established SJS/TEN shows full-thickness, extensive keratinocyte necrosis that develops into subepidermal bullae. Drug-induced hypersensitivity syndrome (DIHS) and exanthema in drug reaction with eosinophilia and systemic symptoms (DRESS) each display a variety of histopathological findings, which may partly correlate with the clinical manifestations. Although the histopathology of DRESS is nonspecific, the association of two or more of the four patterns—eczematous changes, interface dermatitis, acute generalized exanthematous pustulosis- (AGEP-) like patterns, and EM-like patterns—might appear in a single biopsy specimen, suggesting the diagnosis and severe cutaneous manifestations of DRESS. Cutaneous dendritic cells may be involved in the clinical course. AGEP typically shows spongiform superficial epidermal pustules accompanied with edema of the papillary dermis and abundant mixed perivascular infiltrates. Mutations in IL36RN may have a definite effect on pathological similarities between AGEP and generalized pustular psoriasis. |
| format | Article |
| id | doaj-art-3849dc9c16e846be9d96fbe69051c801 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-3849dc9c16e846be9d96fbe69051c8012025-02-03T06:00:59ZengWileyJournal of Immunology Research2314-88612314-71562017-01-01201710.1155/2017/69283636928363Immunohistopathological Findings of Severe Cutaneous Adverse Drug ReactionsMari Orime0Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, JapanDiagnosis of severe cutaneous adverse drug reactions should involve immunohistopathological examination, which gives insight into the pathomechanisms of these disorders. The characteristic histological findings of erythema multiforme (EM), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) provide conclusive evidence demonstrating that SJS/TEN can be distinguished from EM. Established SJS/TEN shows full-thickness, extensive keratinocyte necrosis that develops into subepidermal bullae. Drug-induced hypersensitivity syndrome (DIHS) and exanthema in drug reaction with eosinophilia and systemic symptoms (DRESS) each display a variety of histopathological findings, which may partly correlate with the clinical manifestations. Although the histopathology of DRESS is nonspecific, the association of two or more of the four patterns—eczematous changes, interface dermatitis, acute generalized exanthematous pustulosis- (AGEP-) like patterns, and EM-like patterns—might appear in a single biopsy specimen, suggesting the diagnosis and severe cutaneous manifestations of DRESS. Cutaneous dendritic cells may be involved in the clinical course. AGEP typically shows spongiform superficial epidermal pustules accompanied with edema of the papillary dermis and abundant mixed perivascular infiltrates. Mutations in IL36RN may have a definite effect on pathological similarities between AGEP and generalized pustular psoriasis.http://dx.doi.org/10.1155/2017/6928363 |
| spellingShingle | Mari Orime Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions Journal of Immunology Research |
| title | Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions |
| title_full | Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions |
| title_fullStr | Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions |
| title_full_unstemmed | Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions |
| title_short | Immunohistopathological Findings of Severe Cutaneous Adverse Drug Reactions |
| title_sort | immunohistopathological findings of severe cutaneous adverse drug reactions |
| url | http://dx.doi.org/10.1155/2017/6928363 |
| work_keys_str_mv | AT mariorime immunohistopathologicalfindingsofseverecutaneousadversedrugreactions |