Background: Lymphocyte-poor graft-versus-host-reaction (GVHR) and toxic epidermal necrolysis (TEN) share some histological resemblance. In both diseases, factor-XIIIa-positive dendrocytes show some morphological changes, probably as a response to altered cytokine environment. Objective: To study the ultrastructural aspect of boosted dendrocytes in GVHR and TEN. Methods: Sixty GVHR and 25 TEN lesions were examined using immunohistochemistry. Among them, 6 dendrocyte-rich cases of each disease were studied by electron microscopy. Results: Dendrocyte activation with enlarged endoplasmic reticulum, and collagen fiber and mast cell granule phagocytosis were evidenced in both diseases. Depletion in dendrocytes was only encountered in a few GVHR cases exhibiting specifically a sclerotic aspect in the superficial dermis. Conclusion: Factor-XIIIa-positive dendrocytes probably play a role in the regulation of the connective tissue remodeling that may accompany epidermal destruction.

Keywords:
Graft-versus-host reaction, Toxic epidermal necrolysis, Factor XIIIa, Dendrocyte, Wound healing
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