Lyell's syndrome: histological, immunohistochemical and serological observations

Observations of Lyell's syndrome in two girls, one 2 and the other 7 years of age, investigated serologically, histologically and by immunofluorescent technique, are reported. In both cases. the disease had been preceded by a prolonged or repeated treatment with acetylsalicylic acid, in the first case in combination with sulphonamides and antibiotics and in the second in combination with mephenytoin. Immunofluorescent staining revealed immunoglobulins in subepidermal blisters and along the dermal vessels. Acetylsalicylic acid has been assumed to have been one of the causative factors of the violent progression of toxic epidermal necrolysis, probably by an antigen-antibody reaction. This has been supported by serologic demonstration of antibodies to acetylsalicylic acid in both cases.