摘要
患者男,29岁。因面颈、躯干四肢皮疹伴发热1月余收住院,入院前曾服用抗癫痫药奥卡西平和拉莫三嗪5个月。1个月前出现皮疹、发热,皮损最初以大面积表皮剥脱及黏膜损伤为主,诊断为中毒性表皮坏死松解症(TEN),予糖皮质激素及丙种球蛋白治疗。住院期间及前后因癫痫换用多种抗癫痫药,病情反复,皮肤表现转变为以红皮病为主,出现伴嗜酸性粒细胞增多和系统症状的药物反应(DRESS)典型症状。由于长期大剂量糖皮质激素治疗不能控制病情,并出现激素副作用,予环孢素A治疗,病情迅速好转,激素逐渐减量,至停用环孢素A,疾病未再反复。
A case report of the resolution of persistent anticonvulsant-induced drug reaction with eosinophilia and systemic symptoms（ DRESS） syndrome following cyclosporine with corticosteroids treatment. A 29-year-old man presented with generalized skin eruption and fever for more than a month. He had been taking anticonvulsant oxcarbazepineand lamotrigine for 5 months defore. Initially,generalized blisters,epidermal detachment and mucosal erosions led to the diagnosis of toxic epidermal necrolysis（ TEN）.We immediate withdrawal the suspected drugs. Stemic corticosteroids and intravenous human immunoglobulins（ IVIg） were prescribed. In order to withdraw the offending drug,we changed the anticonvulsant for many times,but manifests still repeated and cutaneous eruption turned into erythroderma,typical symptoms of drug reactions（ DRESS） with eosinophilia and systemic symptoms. A long course of systemic corticosteroids did not work,and the adverse effects shown. Subsequently treated with cyclosporine to good effect.
出处
《中国医学文摘（皮肤科学）》
2017年第3期304-307,共4页
China Medical Abstracts(Dermatology)
