Lesley E. Rhodes, Ibrahim A. Hashim, P. Jeremy McLaughlin, Peter S. Friedmann
DOI: 10.1080/000155599750010689

Cytokines are important regulators of immune and inflammatory reactions in the skin, and may contribute to inflammatory blister induction. We examined the profiles of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in fluid of spontaneous blisters in the immune-based inflammatory disorders bullous pemphigoid (8 patients), allergic contact dermatitis (5 patients) and toxic epidermal necrolysis (5 patients). These were compared with levels in 9 patients with burns, i.e. inflammatory blisters of non-immune aetiology, and 4 patients with blisters of physical origin. Very high levels of IL-6 were found in bullous pemphigoid and toxic epidermal necrolysis (p<0.001) compared with non-inflammatory and burn blisters. TNF-α levels were high in bullous pemphigoid and burns, but undetectable in non-inflammatory blisters. The pattern in bullous pemphigoid (very high IL-6, high TNF-α) differed substantially from toxic epidermal necrolysis (very high IL-6, low TNF-α), while burns and allergic contact dermatitis showed lesser elevation of both cytokines. Hence, differences in cytokine profiles were identified, although the relevance to underlying pathomechanisms is uncertain.