阿司匹林致中毒性表皮坏死松解症1例分析

Analysis of One Case of Toxic Epidermal Necrolysis Induced by Aspirin

目的探讨1例口服阿司匹林致中毒性表皮坏死松解症(toxic epidermal necrolysis,TEN)的治疗经验。方法分析2019年6月发生的1例由阿司匹林导致的中毒性表皮坏死松解症的病例资料,总结其发生的机制和治疗方案。结果患者因2年前行经皮冠状动脉介入术(PCI)需服用抗凝药物。服用阿司匹林后次日出现散在皮疹,并逐渐融合成大片,随后皮疹变为水疱,皮肤溃破,并大片表皮剥脱。考虑为阿司匹林所致的TEN,停用阿司匹林,积极抗过敏及对症支持治疗后患者皮肤症状逐渐缓解。结论阿司匹林临床应用中有发生TEN的可能。药物导致的TEN,早期识别、停用可疑药物和积极对症处理是治疗成功的关键因素。

Objective To probe the experience learned from the treatment of toxic epidermal necrolysis(TEN)induced by aspirin.Methods The possible causes of TEN and treatment protocols were studied and summarized by analyzing the medical records of a patient in June 2019.Results The patient needed oral anticoagulation because of percutaneous coronary intervention(PCI)two years ago.On the second day after taking oral aspirin,the patient developed red rash before some of the maculae were gradually fused into a large area.Over the next few days,blisters appeared and were ulcerated,and epidermis was exfoliated.TEN induced by aspirin was considered and aspirin was immediately stopped so that the symptoms on the patient's skin were relieved gradually via anti-allergic therapy and symptomatic supportive treatment.Conclusion TEN may be induced by aspirin.Early identification,suspension of suspected medicine and effective treatment are the key to cure of drug-induced TEN.