BACKGROUND The clinical manifestations of drug eruption are complex and diverse,which can lead to missed diagnosis or misdiagnosis.The clinical manifestations of drug eruption caused by compound honeysuckle have not b...BACKGROUND The clinical manifestations of drug eruption are complex and diverse,which can lead to missed diagnosis or misdiagnosis.The clinical manifestations of drug eruption caused by compound honeysuckle have not been reported.CASE SUMMARY A 20-year-old man was admitted to our department of dermatology due to erythema and papules on the chest and abdomen with pruritus for 3 d.The next day after taking compound honeysuckle granules,the patient suddenly developed a rash and intense itching on his chest and abdomen.Physical examination revealed diffuse red needle-cap size macules and papules with welldefined borders on the chest and abdomen,and discoloration after finger pressure.No abnormality was observed in other areas of the skin.Back skin scratch was positive.White blood cells,eosinophil count and eosinophil ratio were higher than normal.Histopathological examination of the skin lesions on the left abdomen revealed intercellular edema,blurred focal basal cell layers,and focal lymphocyte infiltration in the superficial dermis and perivascular areas.Immunohistochemistry showed CD3+,CD4+and CD8+T lymphocytes.The diagnosis was drug eruption with special manifestations induced by compound honeysuckle.The skin lesions completely subsided without pruritus after 2 wk of antihistamine and hormone therapy.Follow-up for>1 mo showed no recurrence.CONCLUSION Chinese patent medicine compound honeysuckle granules can induce allergic reaction and rare skin damage.展开更多
Purpose To review the current progress in epidemiology, etiology, clinical manifestation, and pathophysiology of severe cutaneous adverse drug reactions （SCADRs）. Data sources Data were acquired by using Blackwell-S...Purpose To review the current progress in epidemiology, etiology, clinical manifestation, and pathophysiology of severe cutaneous adverse drug reactions （SCADRs）. Data sources Data were acquired by using Blackwell-Synergy, PubMed, original articles published in the main Chinese journals and related medical textbooks materials. Study selection and data extraction Throughout the literature review 49 articles were selected. Results SCADRs cases are rare, however, the implication is life threatening with significant mortality rates. Epidemiology studies have shown various incidences from different regions, gender, age, race and concurrent illness. There are typical signs and symptoms for each type of SCADRs, but this is not always so. Drugs associated with inducing SCADRs are anticonvulsants, antibiotics, NSAIDs and antirheumatic drugs. In some countries, especially in Asia, traditional drugs are often the cause of SCADRs. Genetic polymorphisms and viral infections are predisposition factors of SCADRs. Patients with certain genetic alleles and underlying diseases are vulnerable to SCADRs. The exact pathogenesis of SCADRs is not well defined. Nonetheless, recent study showed that reactive metabolites and immunological processes have a significant role in SCADRs. Conclusions The different SCADRs reactions are attributed by different intrinsic factors, such as genetic polymorphisms, gender, age and race as well as extrinsic factors, such as underlying diseases. Different regions and culprit drugs also play a role in the various types of SCADRs.展开更多
文摘BACKGROUND The clinical manifestations of drug eruption are complex and diverse,which can lead to missed diagnosis or misdiagnosis.The clinical manifestations of drug eruption caused by compound honeysuckle have not been reported.CASE SUMMARY A 20-year-old man was admitted to our department of dermatology due to erythema and papules on the chest and abdomen with pruritus for 3 d.The next day after taking compound honeysuckle granules,the patient suddenly developed a rash and intense itching on his chest and abdomen.Physical examination revealed diffuse red needle-cap size macules and papules with welldefined borders on the chest and abdomen,and discoloration after finger pressure.No abnormality was observed in other areas of the skin.Back skin scratch was positive.White blood cells,eosinophil count and eosinophil ratio were higher than normal.Histopathological examination of the skin lesions on the left abdomen revealed intercellular edema,blurred focal basal cell layers,and focal lymphocyte infiltration in the superficial dermis and perivascular areas.Immunohistochemistry showed CD3+,CD4+and CD8+T lymphocytes.The diagnosis was drug eruption with special manifestations induced by compound honeysuckle.The skin lesions completely subsided without pruritus after 2 wk of antihistamine and hormone therapy.Follow-up for>1 mo showed no recurrence.CONCLUSION Chinese patent medicine compound honeysuckle granules can induce allergic reaction and rare skin damage.
文摘Purpose To review the current progress in epidemiology, etiology, clinical manifestation, and pathophysiology of severe cutaneous adverse drug reactions （SCADRs）. Data sources Data were acquired by using Blackwell-Synergy, PubMed, original articles published in the main Chinese journals and related medical textbooks materials. Study selection and data extraction Throughout the literature review 49 articles were selected. Results SCADRs cases are rare, however, the implication is life threatening with significant mortality rates. Epidemiology studies have shown various incidences from different regions, gender, age, race and concurrent illness. There are typical signs and symptoms for each type of SCADRs, but this is not always so. Drugs associated with inducing SCADRs are anticonvulsants, antibiotics, NSAIDs and antirheumatic drugs. In some countries, especially in Asia, traditional drugs are often the cause of SCADRs. Genetic polymorphisms and viral infections are predisposition factors of SCADRs. Patients with certain genetic alleles and underlying diseases are vulnerable to SCADRs. The exact pathogenesis of SCADRs is not well defined. Nonetheless, recent study showed that reactive metabolites and immunological processes have a significant role in SCADRs. Conclusions The different SCADRs reactions are attributed by different intrinsic factors, such as genetic polymorphisms, gender, age and race as well as extrinsic factors, such as underlying diseases. Different regions and culprit drugs also play a role in the various types of SCADRs.
