Fixed drug eruption: a disease mediated by self-inflicted responses of intraepidermal T cells.
It is difficult to dissect disease-causing T cells and anti-inflammatory T cells in a biopsy specimen obtained at a given time, which would represent a single time point in the development of the lesions. In fixed drug eruption (FDE), the resting lesions long after clinical resolution have many clues to identify the disease-causing T cells, because they contain a large homogeneous population of CD8(+) T cells that are distributed along the epidermal basal layer and have the capacity to rapidly produce large amounts of IFN-gamma. These intraepidermal CD8(+) T cells are likely to be a major actor in epidermal injury observed in FDE lesions. In this review, we ask how they arise and how they cause epidermal injuries, which present with a wide spectrum of clinical manifestations and are often mistaken as signs of other skin disease.
Shiohara
Tetsuo
T
Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, Japan. tpshio@kyorin-u.ac.jp
Mizukawa
Yoshiko
Y
D018414:CD8-Positive T-Lymphocytes / Q000502:physiology*; D003875:Drug Eruptions / Q000276:immunology* / Q000473:pathology; D004817:Epidermis / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000096:biosynthesis; D012867:Skin / Q000276:immunology* / Q000473:pathology
D007371:Interferon-gamma