Stanley J, Fallon-Pellicci V
Arch Dermatol. 1978 Sep;114(9):1350-3.
A clinically characteristic hypersensitivity reaction to phenytoin occurred in two patients three to four weeks after they started phenytoin therapy. It consisted of a characteristic rash, fever, tender generalized lymphadenopathy, leukocytosis with atypical lymphocytes, and eosinophilia. One patient had liver function abnormalities suggestive of hepatitis, as have most previously reported cases. The rash was pruritic and generalized; it consisted of irregular, ill-defined macular erythema in patches with superimposed follicular papules and massive edema of the face and periorbital region. Facial edema is characteristic of this syndrome. In one case the rash progressed to include follicular pustules and resolved with superficial desquamation. Histopathologic specimens from both cases showed a dense, superficial lymphohistiocytic infiltrate in the dermis and epidermal spongiosis. Intraepidermal pustules were present in one patient. The importance of recognizing this syndrome is stressed because it is potentially fatal.
两名患者在开始苯妥英治疗三到四周后发生了对苯妥英的具有临床特征的超敏反应。它表现为特征性皮疹、发热、全身性压痛性淋巴结病、伴有非典型淋巴细胞的白细胞增多以及嗜酸性粒细胞增多。一名患者出现提示肝炎的肝功能异常，此前大多数报道的病例也是如此。皮疹瘙痒且全身性；由不规则、边界不清的斑片状红斑组成，伴有叠加的毛囊丘疹以及面部和眶周区域的大量水肿。面部水肿是该综合征的特征。在一例中，皮疹进展至包括毛囊脓疱，并随着表皮剥脱而消退。两例的组织病理学标本均显示真皮内有密集的浅表淋巴细胞 - 组织细胞浸润以及表皮海绵形成。一名患者存在表皮内脓疱。强调认识该综合征的重要性，因为它可能是致命的。
