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Medline ® Abstract for Reference 152

of 'Cutaneous side effects of conventional chemotherapy agents'

152
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Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin.
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Viard I, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, Hunziker T, Saurat JH, Tschopp J, French LE
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Science. 1998;282(5388):490.
 
Toxic epidermal necrolysis (TEN, Lyell's syndrome) is a severe adverse drug reaction in which keratinocytes die and large sections of epidermis separate from the dermis. Keratinocytes normally express the death receptor Fas (CD95); those from TEN patients were found to express lytically active Fas ligand (FasL). Antibodies present in pooled human intravenous immunoglobulins (IVIG) blocked Fas-mediated keratinocyte death in vitro. In a pilot study, 10 consecutive individuals with clinically and histologically confirmed TEN were treated with IVIG; disease progression was rapidly reversed and the outcome was favorable in all cases. Thus, Fas-FasL interactions are directly involved in the epidermal necrolysis of TEN, and IVIG may be an effective treatment.
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Department of Dermatology, Geneva University Medical School, CH-1211 Geneva 4, Switzerland.
PMID