Abstract
T cells present in human skin are involved in cutaneous immune surveillance but can also contribute actively to inflammatory skin diseases. In healthy human adult skin, T cells mainly belong to the CD45RO+ memory population. In contrast, human fetal skin contains predominantly CD45RA+ naive T cells. In this study, we elucidated the T cell composition in human skin samples after birth to unravel whether the change of the microenvironment influences the cutaneous T cell repertoire. Double-immunofluorescence staining on skin cryostat sections revealed that the majority of CD3+ T cells in human neonatal epidermis as well as dermis displayed a memory phenotype and that their numbers progressively increased with age. While naive T cells were observed in neonatal dermis, these cells were not present in neonatal epidermis. Some rare naive T cells appeared in infant epidermis. Taken together our results show that the composition of T cells in human neonatal skin is comparable in some aspects to adult as well as fetal skin and shows that the change of the microenvironment is accompanied by an altered T cell arrangement of the skin.
Highlights
Toxic-Epidermal-Necrolysis might be a severe delayed reaction to drugs, so in-vitro assessment could be suitable
Toxic Epidermal Necrolysis (TEN) is a rare but life-threatening cutaneous eruption with systemic features mainly caused by drugs in which there is at least 30% of skin detachment so in-vitro assessment might be useful to avoid insecure drug challenges [1]
Allergy study was performed after informed consent: A Basophile activation Test (BAT) and Lymphocyte-TransformationTest (LTT) were carried out in order to elucidate the etiology of this complex Syndrome
Summary
A 33 year-old female suffering from Multiple-Sclerosis (MS) was receiving Beta1a-Interferon from the last 2.5 months, Deflazacort 1 month and Ibuprofen occasionally. She consulted the emergency department due to confluent dianiform maculae, denudating blisters and subsequent systemic symptoms which led to toxic epidermal necrolysis after skin biopsy result. Cyclosporine, Prednisone, Zinc-Sulfate baths and complete discontinuation of implicated medication achieved total symptom relief. A Basophil Activation Test (BAT) and Lymphocyte-TransformationTest (LTT) were carried out using Beta1aInterferon, Deflazacort and Ibuprofen at different dilutions for each culprit medication (1/1,1/10,1/102,1/103). Glatiramer-Acetate(GA) hasnt been reported as TEN/SJS cause, neurology-department considered it as a secure alternative to Beta-1a-Interferon so it was in-vitro assessed likewise
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