What are typical histopathologic findings in skin specimens in the workup of Stevens-Johnson syndrome (SJS)?

Updated: Jan 17, 2019
  • Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Minimal dermal inflammatory cell infiltrate and full-thickness necrosis of the epidermis are typical histopathologic findings in patients with Stevens-Johnson syndrome. Histopathologic examination of the skin can also reveal the following:

  • Changes in the epidermal-dermal junction ranging from vacuolar alteration to subepidermal blisters

  • Dermal infiltrate: Superficial and mostly perivascular

  • Apoptosis of keratinocytes

  • CD4+ T lymphocytes predominating in the dermis; CD8+ T lymphocytes predominating in the epidermis; the dermoepidermal junction and epidermis is infiltrated mostly by CD8+ T lymphocytes


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