Yeung Chi Keung, Ma Shing Yan, Hon Charmine, Peiris Malik, Chan Henry Hin Lee
Department of Medicine, Queen Mary Hospital, The University of Hong Kong.
Acta Derm Venereol. 2003;83(3):179-82. doi: 10.1080/00015550310007166.
Toxic epidermal necrolysis and Stevens-Johnson syndrome are serious cutaneous reactions associated with significant mortality and morbidity. Eight patients with toxic epidermal necrolysis and eight patients with Stevens-Johnson syndrome were admitted consecutively to a single centre between August 2001 and March 2002. An aetiological study including viral serology and PCR was performed in view of the clustering of admissions related to these two conditions. The majority of cases were drug induced, the drug most commonly involved being allopurinol (toxic epidermal necrolysis, 50%; Stevens-Johnson syndrome, 13%). Two cases were related to drug abuse. Possible aetiological co-factors were cancers, radiotherapy and renal failure. No association with viral infection, including human herpesvirus-6 and parvovirus B19, was detected in the present series. Early diagnosis and prompt withdrawal of suspected drugs remain the most important measures in managing this condition. Further studies to identify the co-factors precipitating severe cutaneous drug reactions are warranted.
中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征是严重的皮肤反应，伴有显著的死亡率和发病率。2001年8月至2002年3月期间，8例中毒性表皮坏死松解症患者和8例史蒂文斯-约翰逊综合征患者连续入住同一中心。鉴于这两种病症相关入院病例的聚集情况，开展了一项包括病毒血清学和聚合酶链反应的病因学研究。大多数病例是药物引起的，最常涉及的药物是别嘌醇（中毒性表皮坏死松解症，50%；史蒂文斯-约翰逊综合征，13%）。两例与药物滥用有关。可能的病因协同因素有癌症、放疗和肾衰竭。在本系列病例中未检测到与病毒感染的关联，包括人类疱疹病毒6型和细小病毒B19。早期诊断和迅速停用可疑药物仍然是处理这种病症最重要的措施。有必要开展进一步研究以确定引发严重皮肤药物反应的协同因素。
