What are the histologic findings in conjunctival biopsies of active ocular disease in 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

Conjunctival biopsies from patients with active ocular disease show subepithelial plasma cells and lymphocyte infiltration. Lymphocytes also are present around vessel walls. The predominant infiltrating lymphocyte is the helper T cell.

Immunohistology of the conjunctiva reveals numerous HLA-DR–positive cells in the substantia propria, vessel walls, and epithelium. In the epithelium, HLA-DR is presented by Langerhans cells, macrophages, and activated T cells.

Immunoreactant deposition in vessel walls, comprised of immunoglobulin and complement components, is another prominent feature.


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