Background: A severe form of fixed drug eruption (FDE)-clinically and histologically mimics toxic epidermal necrolysis (TEN) but, unlike TEN, resolves spontaneously upon withdrawal of the causative drug. Objective and Methods: We reported a case of a severe FDE caused by mefenamic acid that spontaneously resolved without use of systemic corticosteroids. To clarify the phenotype of the T cells responsible for clinical resolution of FDE, we kinetically examined γ-interferon (IFN-γ), interleukin (IL)-2, IL-4 and IL-10 production by peripheral blood T cells of the patient before and after oral challenge with the causative drug using flow cytometry. Results: We found that the proportions of CD4+and CD8+T cells capable of producing IFN-γand IL-4 remained unchanged after challenge, while those of CD4+and CD8+T cells capable of producing IL-10 dramatically increased after challenge. The frequency of CD8+T cells capable of producing IL-2 decreased after challenge. Conclusion: These results suggest that expansion of IL-10-producing CD4+and CD8+T cells may be responsible for spontaneous resolution of a severe form of FDE.
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