TNF and toxic epidermal necrolysis: To explore novel therapeutic approaches, we systematically reviewed the underlying immunopathological mechanisms of ICI-induced TEN, which primarily involve: 1) Heightened T-cell activity directed against antigens shared by tumor and normal tissues, increased production of autoantibodies, and elevated levels of pro-inflammatory cytokines leading to aberrant immune activation (16); 2) Macrophage infiltration in lesional skin with high expression of TNF and CXCL10, which recruits CXCR3+ cytotoxic T lymphocytes (CTLs) to skin lesions, resulting in epidermal detachment and necrosis.