非布司他致剥脱性皮炎

Exfoliative dermatitis due to febuxostat

1例77岁男性患者因高尿酸血症给予非布司他40 mg口服、1次/d.用药当晚双手出现散在红色皮疹.用药第8天皮疹扩散至全身,因肺部感染当晚静脉滴注替卡西林钠克拉维酸钾 3.2 g.次日凌晨患者全身皮疹加重,伴瘙痒,停用非布司他和替卡西林钠克拉维酸钾.一次性静脉注射地塞米松2 mg.停用非布司他第4天患者全身皮肤潮红、干燥,伴刺痛瘙痒,静脉滴注地塞米松10 mg、1次/d.第6天患者全身皮肤脱落,呈剥脱样,累及范围达100%;第11天诊断为剥脱性皮炎,静脉滴注甲泼尼龙琥珀酸钠40 mg、1次/d,人免疫球蛋白20 g、1次/d;第16天患者全身皮肤干燥,仍有脱屑;第19天皮疹基本消失.

A 77-year-old male patient with hyperuricemia received febuxostat 40 mg orally once daily.On the night of the first dose administration, red rash appeared on his hands.On day 8, the skin rashes progressively spread over his entire body.The patient received an IV infusion of ticarcillin disodium/clavulanate potassium 3.2 g due to his pulmonary infection on the night of the same day.The next morning his symptoms of rashes worsened and accompanied with pruritus.Febuxostat and ticarcillin disodium/clavulanate potassium were withdrawn.He was given a temporary intravenous injection of dexamethasone 2 mg.On day 4 of drug withdrawal, his whole body turned red, dry and accompanied with severe pain and pruritus.He received an IV infusion of dexamethasone 10 mg once daily.On day 6, his skin had exfoliation （100% of body surface area）.On day 11,he was diagnosed with exfoliative dermatitis and received an IV infusion of methylprednisolone 40 mg once daily and human immune globulin 20 g once daily.On day 16, his systemic skin became dry with desquamation.On day 19, his erythra almost disappeared.