CD8+ lymphocytes in the blister fluid of severe acute cutaneous graft-versus-host disease: further similarities with toxic epidermal necrolysis.
BACKGROUND
Graft-versus-host disease (GvHD) remains the major toxicity of allogeneic bone marrow transplantation (BMT). In the acute form of the disease, the differential diagnosis includes viral rash and drug eruptions.


METHODS
We report two patients with chronic myeloid leukemia submitted to allogeneic BMT who developed a severe form of acute cutaneous GvHD, with clinical and histological pictures mimicking toxic epidermal necrolysis (TEN).


RESULTS
We found a predominance of peripheral CD8+ T lymphocytes and, at the same time, studying the cellular profile of the blister fluid, just in the beginning of blister eruption, we also found a high proportion of CD8+ T lymphocytes, mainly CD8+CD57-.


CONCLUSIONS
These data are in agreement with previous reports of the presence of CD8+ T cells in the blister fluid of patients with TEN, further emphasizing similar immunoinflammatory pathways in both diseases.
Correia
O
O
Department of Dermatology, Instituto Português Oncologia, Porto, Portugal. osvaldo.correia@netc.pt
Delgado
L
L
Barbosa
I L
IL
Domingues
J C
JC
Azevedo
R
R
Vaz
C P
CP
Pimentel
P
P
D000208:Acute Disease; D000328:Adult; D001768:Blister / Q000175:diagnosis* / Q000276:immunology; D001826:Body Fluids / Q000166:cytology*; D018414:CD8-Positive T-Lymphocytes; D003937:Diagnosis, Differential; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis*