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Erythema multiforme‐like contact reaction due to liquid‐formulated 2,2‐dibromo‐3‐nitrilopropionamide: involvement of cytotoxic T‐lymphocyte reaction
Author(s) -
Senoh A.,
Tokuyama Y.,
Nakayama Y.,
Fujii K.,
Iwatsuki K.
Publication year - 2009
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2009.03455.x
Subject(s) - erythema multiforme , cytotoxic t cell , immunology , mixed lymphocyte reaction , t lymphocyte , medicine , hypersensitivity reaction , lymphocyte , dermatology , chemistry , t cell , immune system , biochemistry , in vitro
Summary 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 ciclosporin 2.5–3 mg/kg successfully controlled the disease. DBNPA‐induced, generalized EM‐like eruptions may be mediated by cytotoxic T‐lymphocytes.