去痛片致大疱性表皮松解症

Epidermolysis bullosa due to compound aminopyrine phenacetin tablets

1例51岁男性患者因头痛自行服用去痛片(每片含氨基比林150 mg、非那西丁150 mg、咖啡因50 mg、苯巴比妥15 mg)2片,2次/d。第2天,患者全身出现红斑样皮疹,瘙痒明显伴疼痛,遂停用去痛片。第3天皮肤斑疹部分融合成片,其上出现大小不等松弛性水疱或大疱,口腔和生殖器皮肤-黏膜交界处出现糜烂。给予甲泼尼龙、葡萄糖酸钙注射液静脉滴注,依巴斯汀片、富马酸酮替芬片口服,并加强皮肤护理。6 d后皮疹颜色变淡,大部分水疱及大疱干涸结痂。甲泼尼龙逐渐减量。11 d后患者皮肤红斑明显消退,水疱及大疱干涸,表皮呈片状脱屑,改为泼尼松龙片口服。13 d后患者全身皮疹基本消退。

A 51-year-old male patient took by himself oral compound aminopyrine phenacetin tablets(each tablet containing aminopyrine 150 mg,phenacetin 150 mg,caffeine 50 mg,and phenobarbital 15 mg)2 tablets twice daily for headache.On the second day,the patient developed erythematous rash all over the body,accompanied by obvious itching and pain.Then the compound aminopyrine phenacetin tablets were stopped.On the third day,some of the macula fused into a piece,on which different sizes of loose blisters or bullae appeared.And erosion occurred at the junction of the skin and mucous of the mouth and genitals.Intravenous infusions of methylprednisolone and calcium gluconate injection,oral ebastine tablets and ketotifen fumarate tablets,and skin care were given.Six days later,his rash became lighter,most of the blisters and bullae dried up and scabbed.The dose of methylprednisolone was gradually reduced.Eleven days later,the erythema obviously improved,blisters and bullae dried up,and flaky desquamation on the epidermis occurred.Intravenous infusion of methylprednisolone was changed to oral prednisolone(20 mg/d).Thirteen days later,the rash subsided basically.