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Toxic epidermal necrolysis (TEN) is the clinical result of apoptotic keratinocyte death. Keratinocytes normally express the death receptor Fas (CD95), and the triggering of this receptor by the Fas ligand (FasL) results in apoptosis.
In a study of the mechanisms of TEN, FasL was detected in the serum of patients with TEN (n=5), but not in healthy controls or patients with other exanthematous drug eruptions. Expression of FasL in skin was detected only in patients with TEN. FasL expressed in the skin of patients with TEN was lethal to other cells, but specific monoclonal antibodies to FasL blocked this toxicity. To evaluate whether intravenous immunoglobulin (IVIG), prepared from the pooled plasma of healthy donors, interferes with FasL-induc…