الفهرس 
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Abstract
The study was carried out at the Department of Dermatology, Venereology and Andrology, Assuit University Hospitals. Twenty patients presented with adverse cutaenous drug eruption (Twelve patients with Steven-Johnson Syndrome and Toxic Epidermal Necrolysis, eight patients with erythema multiforme) were recruited from the Outpatient Clinic of Dermatology and Department of Dermatology, Venereology and Andrology, Assuit University Hospitals. In the period from October 2017 to December 2018 and fourteen healthy controls were also enrolled in the study.
As IL-21 is one of the interleukins which has a cytotoxic destructive effect on keratinocytes and their apoptosis with epidermal necrosis. Its serum level was investigated in patients with life- threatening severe cutaneous drug reactions (SJS and TEN syndrome) with comparison to their minor form (EM), healthy control subjects and before and after treatment. Also results were correlated with disease severity.
Patients were clinically examined, assessed clinically using score of Toxic Epidermal Necrolysis (SCORTEN) scale and percentage of body surface area involvement, together with assessment of all data about age, sex, current treatment. Serum IL-21 level was measured using ELISA.
Our results showed that serum level of IL- 21 was higher in both EM and SJS/TEN groups compared with Healthy Controls and serum level of IL- 21 correlate positively with measures of disease severity (SCORTEN and BSA% involvement). Also serum level of IL- 21 was decreased in patients group after one month of corticosteroid treatment.
from the previous findings we concluded that
• Serum level of IL- 21 was significantly elevated in EM and SJS/TEN patients and may be involved in the pathogenesis of EM and SJS/TEN.
• Serum level of IL-21 may influence the severity of EM and SJS/TEN drug reactions. The findings of the present study provide a preliminary indication that serum IL-21 could be used as a marker for the severity of SJS/TEN and for patient prognosis.