Toxic epidermal necrolysis. A study of the sweat glands.

Toxic epidermal necrolysis (TEN) is a rare dermatological emergency which is caused by drugs and results in a high morbidity and a mortality rate of 20-30%. Ten confirmed cases of TEN were retrieved and the sweat glands were examined. Abnormalities of the sweat duct were found in all the cases and included basal vaculopathy, increased lymphocytic infiltration, basal apoptosis, basal cell hyperplasia and necrosis of the duct. Destruction and loss of the distal duct was present in 40% of the cases and was accompanied by dilatation of the proximal duct. In all cases, the proximal duct was involved to a lesser degree and in continuity with the distal duct, supporting the possibility of cytokine action. The secretory gland was normal. The presence of a significant reduction of sweat ducts in a disease process that involves 30-100% of the total body surface area is of clinical importance.