注射用磺苄西林致剥脱性皮炎1例

One case of exfoliative dermatitis induced by sulbenicillin for injection

1例77岁男性患者因肾功能异常,腹透8个月,乏力、纳差2 d入院治疗。入院第10天因肺部感染静脉输注磺苄西林(3 g,ivgtt),输注过程中患者出现全身皮肤瘙痒,喘憋明显,呼吸困难,测BP 89/50 mm Hg。立即停用注射用磺苄西林,并给予苯海拉明(20 mg,im)和地塞米松(5 mg,ivgtt)进行治疗,2 h后患者喘憋症状好转,皮肤瘙痒症状减轻。停药后第1天,患者口唇出现水泡,全身水肿,阴囊肿大,皮肤瘙痒较前加重,予西替利嗪(10 mg,po)治疗。停药第6天,患者口唇黏膜及颈部、腋下皮肤片状剥脱。停药第11天,患者全身皮肤剥脱,经复方倍他米松(1 m L,im)等对症治疗,皮疹逐渐好转。停药45 d后,患者皮肤均被新生皮肤覆盖,但遗留色素沉着。

One 77-year-old male patient was admitted to hospital for renal dysfunction, peritoneal dialysis for eight months, fatigue and anorexia for 2 days. On the tenth day after admission, sulbenicillin (3 g, ivgtt) was used for lung infection.During infusion, the patient suffered from systemic skin itch, obvious wheezing and dyspnea. The blood pressure was 89/50 mm Hg. Sulbenicillin was stopped immediately, the symptoms of choke and skin itch improved after diphenhydramine (20 mg, im) and dexamethasone (5 mg, ivgtt) treatment. One day later, the patient developed lip blisters, edema, oscheocele and aggravating itch.Cetirizine (10 mg, po) was given to the patient. On the sixth day with sulbenicillin withdrawal, lip mucosa and skins of neck and underarms presented sheet exfoliation. On the eleventh day with drug withdrawal, patient' whole body skin presented exfoliation,compound betamethasone (1 mL, im) was given and the rashes gradually improved. Forty-five days after drug discontinuation, the patient's skin was covered with new skin and the systemic skin pigmentation was left.