Erythema multiforme-like contact reaction due to liquid-formulated 2,2-dibromo-3-nitrilopropionamide: involvement of cytotoxic T-lymphocyte reaction.
Erythema multiforme (EM)-like contact reactions are induced by exposure to various chemicals. We report two industrial workers from a paper mill who presented with generalized EM-like lesions 17 and 10 days, respectively, after accidental exposure to liquid-formulated 2,2-dibromo-3-nitrilopropionamide (DBNPA) 20%. The EM-like lesions appeared as subepidermal blisters associated with many necrotic or apoptotic keratinocytes and dense lymphocytic infiltration in the epidermis. Most of the infiltrating cells in the epidermis were CD8-positive T lymphocytes expressing cytotoxic molecules, including T cell-restricted intracellular antigen (TIA)-1, granzyme B and granulysin. Steroid pulse therapy failed to suppress the development of the lesions sufficiently, but cyclosporin 2.5-3 mg/kg successfully controlled the disease. DBNPA-induced, generalized EM-like eruptions may be mediated by cytotoxic T-lymphocytes.
Senoh
A
A
Department of Dermatology, Mitoyo General Hospital, Kan-onji, Japan.
Tokuyama
Y
Y
Nakayama
Y
Y
Fujii
K
K
Iwatsuki
K
K
D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003602:Cytotoxicity, Immunologic; D004892:Erythema Multiforme / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D009570:Nitriles / Q000633:toxicity*; D009943:Organophosphorus Compounds / Q000633:toxicity*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
D009570:Nitriles; D009943:Organophosphorus Compounds; C007320:2,2-dibromo-3-nitrilopropionamide