依帕司他致多形红斑型药疹

Erythema multiforme-type drug eruption induced by epalrestat

1例56岁女性患者因糖尿病周围神经病变给予依帕司他50 mg口服、3次/d。当天服药3次后(首次用药后约10 h),患者面部出现红色丘疹,头颈部出现风团样红斑。服药第2天,皮疹进行性加重并诊断为多形红斑型药疹。考虑为依帕司他所致,将该药换为硫辛酸注射液,并给予地塞米松、维生素C注射液、葡萄糖酸钙注射液对症治疗。3 d后,患者过敏症状减轻,逐步停用抗过敏药物,其他药物继续使用;6 d后,患者无不适,停药出院。20 d后随访,患者皮疹未复发。

A 56-year-old female patient received epalrestat 50 mg thrice daily orally because of the diagnosis of diabetic peripheral neuropathy.After 3 times of epalrestat treatment that day(about 10 hours after the first medication),the patient developed red papules on the face and patch-like erythema on the head and neck.On day 2 of epalrestat treatment,the rashes were progressively aggravated and the patient was diagnosed with erythema multiforme-type drug eruption.Considering that it might be caused by epalrestat,the drug was replaced by lipoic acid injection and symptomatic treatments with dexamethasone,vitamin C injection,and calcium gluconate injection were given.Three days later,the patient′s allergic symptoms were alleviated.Anti-allergic drugs were phased out gradually while the other drugs were continued.Six days later,the patient had no discomfort and was discharged from the hospital.At 20 days of follow-up,the rashes did not recur.