Ruzicka T, Goerz G
Derm Beruf Umwelt. 1978;26(5):147-55.
The clinical evolution of Lyell' syndrome (LS), its complications, the histological findings, the nosological position and the differentiation from erythema exsudativum multiforme are dealt with. There are at least two etiological forms of LS: the LS caused by staphylococci, and the LS caused by drugs. The former mainly occurs in children, and is caused by staphylococci of the phagous group II, while the latter is mainly caused by sulfonamides, pyrazolones, penicillines, barbiturates and salicylates. The causative responsibility of a certain drug can be proved by three criteria: 1. Relapse of LS after exposure to the same drug. 2. Allergy to the drug taken before the onset of LS. 3. Positive allergy tests. The hypothesis concerning the pathogenesis of LS caused by drugs, the differential diagnosis and therapeutical guidelines are dealt with.
本文探讨了莱尔综合征(LS)的临床演变、并发症、组织学表现、疾病分类位置以及与多形性渗出性红斑的鉴别。LS至少有两种病因形式:由葡萄球菌引起的LS和由药物引起的LS。前者主要发生在儿童中,由噬菌性II组葡萄球菌引起,而后者主要由磺胺类药物、吡唑酮类、青霉素类、巴比妥类和水杨酸盐引起。某种药物的致病责任可通过三个标准来证明:1. 接触同一药物后LS复发。2. LS发病前对所服用药物过敏。3. 过敏试验呈阳性。文中还讨论了药物引起的LS的发病机制假说、鉴别诊断和治疗指南。