{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:43Z","timestamp":1787014063227,"version":"build-2736575974"},"reference-count":5,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T00:00:00Z","timestamp":1500422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stage 4 skin graft\u2010versus\u2010host disease (GVHD) is associated with poor prognosis and high mortality rates. Clinical and histologic similarities with toxic epidermal necrolysis (TEN) make it difficult to distinguish between these 2 life\u2010threatening conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted from a tertiary referral center. Skin biopsies were obtained from 11 patients who developed stage 4 skin GVHD and 11 patients who developed TEN between 2005 and 2012. The CD8+\/CD4+ T lymphocyte ratios were assessed in lesional skin specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Average CD8+and CD4+ cell counts co\u2010expressing CD3 were 126.29 (range 86.42\u2010173.06) and 84.60 (29.87\u2010197.20) for stage 4 skin GVHD patients, and 61.97 (45.79\u2010146.67) and 7.65 (0.00\u201039.50) for TEN patients, respectively. Immunohistochemical studies of stage 4 skin GVHD and TEN skin demonstrated average CD8+\/CD4+ ratios of 1.78 (range 0.69\u20103.09) and 7.33 (1.16\u201012.3), respectively (\n                      <jats:italic>P<\/jats:italic>\n                      = .013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stage 4 skin GVHD and TEN are processes with cytotoxic profiles. TEN is notable for a greater relative depletion of CD4+ T lymphocytes compared with stage 4 skin GVHD, while stage 4 skin GVHD tends to be more inflammatory than TEN. These data suggest an immunohistologic method by which these 2 entities may be distinguished.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cup.12986","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T03:23:18Z","timestamp":1497842598000},"page":"857-860","source":"Crossref","is-referenced-by-count":18,"title":["A pilot study comparing histological and immunophenotypic patterns in stage 4 skin graft vs host disease from toxic epidermal necrolysis"],"prefix":"10.1111","volume":"44","author":[{"given":"Haley","family":"Naik","sequence":"first","affiliation":[{"name":"Department of Dermatology University of California  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7334-0960","authenticated-orcid":false,"given":"Stephen","family":"Lockwood","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Department of Dermatology Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Department of Dermatology Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)90114-1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(72)92764-X"},{"issue":"4","key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1001\/archderm.1972.01620070033013","article-title":"Toxic epidermal necrolysis in a patient with graft\u2010vs\u2010host reaction","volume":"105","author":"Peck GL","year":"1972","journal-title":"Arch Dermatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5700068"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/106002809202600109"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcup.12986","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.12986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:45:39Z","timestamp":1695552339000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.12986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,19]]},"references-count":5,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1111\/cup.12986"],"URL":"https:\/\/doi.org\/10.1111\/cup.12986","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,19]]}}}