Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered to be severity variants of the same disease, which is almost always associated with drug intake. In contrast, erythema multiforme (EM) is a disorder regarded as only rarely caused by drugs. Keratinocyte apoptosis has been shown to play an important part in the pathogenesis of SJS and TEN, whilst its role in EM remains controversial. To determine the expression of apoptosis-associated molecules Fas, Fas ligand (FasL), BcI-2 and Bax in the above disorders, an immunohistochemical anatysis was performed. We studied both lesional skin from thirty patients having drug-induced EM and 5 cases classified within the SJS/TEN spectrum and normal skin samples. We found a keratinocyte overexpression of Fas antigen, an important molecule mediating apoptosis, not only in SJS and TEN but also in EM. Another noteworthy finding was the strong expression of BcI-2, a protein known as blocking apoptosis, along the basal layer and in the dermal infiltrate both in SJS/TEN and in EM. Taken together, these findings suggest that Fas-dependent keratinocyte apoptosis may playa part in the pathogenesis of both SJS/TEN and EM. Fas-mediated cell death may be partially suppressed by the BcI-2 protein.Until recently, most textbooks of medicine considered erythema multi forme (EM) to be a spectrum of disorders that included EM majus, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). A few years ago, some authors suggested that EM majus is different from SJS and TEN, not only in severity but also in the pattern and distribution of the skin lesions, whereas SJS and TEN are only severity variants of a single entity (1-4).This last is almost always associated with drug intake, whilst EM, both in its majus variant and in the form so-called minor, is predominantly caused by preceding infections, notably with herpes simplex virus (HSV), and only rarely by drugs.