Article (Scientific journals)
Delayed reepithelialization and scarring deregulation following drug-induced toxic epidermal necrolysis.
Paquet, Philippe; Jacob, E.; Quatresooz, Pascale et al.
2007In Burns: Journal of the International Society for Burn Injuries, 33 (1), p. 100-4
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Keywords :
Allopurinol/adverse effects; Antimetabolites/adverse effects; Cicatrix, Hypertrophic/chemically induced/pathology; Epidermal Necrolysis, Toxic/etiology/pathology; Female; Humans; Keratinocytes/transplantation; Lupus Erythematosus, Systemic/drug therapy/pathology; Middle Aged; Skin Transplantation/methods/pathology; Transplantation, Homologous
Abstract :
[en] A 51-year-old Caucasian woman developed severe drug-induced toxic epidermal necrolysis (TEN) due to allopurinol. The withdrawal of the culprit drug was unfortunately delayed, and dramatic retardation of reepithelialization was observed. At that stage of disease evolution, an inflammatory cell infiltrate was present in the dermis. Coverage of eroded lesions by frozen cultured keratinocyte allografts failed to hasten reepithelialization compared to ungrafted sites. This unusual protracted TEN evolution was followed by the development of extensive hypertrophic and keloid scars. Several biopsies were taken over 6 months. The histologic presentation of the grafted and ungrafted eroded scar tissues looked similar. Both the number and size of the Factor XIIIa-positive dermal dendrocytes, as well as the number of alpha-actin-positive myofibroblasts showed a marked increase between weeks 2 and 12 after grafting. They were reduced after 6 months when the scarring process was stabilized. alpha1 [IV] collagen was never expressed over the eroded scars. Similar to burn patients, delayed reepithelialization might be a risk factor for abnormal scarring in TEN. Cultured keratinocyte allograft apparently offered no improvement in reepithelialization and did not prevent abnormal scarring in this TEN patient.
Disciplines :
Dermatology
Author, co-author :
Paquet, Philippe ;  Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Jacob, E.;  Centre Hospitalier Universitaire de Liège - CHU
Quatresooz, Pascale  ;  Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Jacquemin, Denise ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie maxillo-faciale et plastique
Pierard, Gérald ;  Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Language :
English
Title :
Delayed reepithelialization and scarring deregulation following drug-induced toxic epidermal necrolysis.
Publication date :
2007
Journal title :
Burns: Journal of the International Society for Burn Injuries
ISSN :
0305-4179
eISSN :
1879-1409
Publisher :
Elsevier, New York, United States - New York
Volume :
33
Issue :
1
Pages :
100-4
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 05 February 2009

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