Macrophages and tumor necrosis factor alpha in toxic epidermal necrolysis

Arch Dermatol. 1994 May;130(5):605-8.


Background: We studied the immunopathologic characteristics of five cases of toxic epidermal necrolysis by using a large panel of antibodies.

Observations: The pattern and amount of the inflammatory cell infiltrate varied according to the stage of the disease. The main constant feature was the prominent involvement of the monocyte-macrophage lineage, including factor XIIIa+HLA-DR+ dendrocytes and CD68+ Mac 387+ macrophages, before and during the epidermal necrosis. The number of CD4+ and CD8+ lymphocytes was comparatively small. This was associated with a dense labeling of the epidermis for tumor necrosis factor alpha.

Conclusions: Cells of the monocyte-macrophage lineage largely outnumber lymphocytes in the lesions of toxic epidermal necrolysis. Tumor necrosis factor alpha is likely a major cytokine that is responsible for necrosis.

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Leukocyte Count
  • Lymphocytes
  • Macrophages
  • Male
  • Middle Aged
  • Stevens-Johnson Syndrome / immunology*
  • Stevens-Johnson Syndrome / pathology
  • Tumor Necrosis Factor-alpha / biosynthesis


  • Tumor Necrosis Factor-alpha