Wolf Ronni, Davidovici Batya, Matz Hagit, Mahlab Keren, Orion Edith, Sthoeger Zev M
Dermatology Unit, Kaplan Medical Center, Rechovot, Israel.
Int Arch Allergy Immunol. 2006;141(3):308-10. doi: 10.1159/000095437. Epub 2006 Aug 28.
A 43-year-old man developed a skin eruption characterized by 'macules with blisters' typical to Stevens-Johnson syndrome, as well as erosions of the lips and buccal mucosa, 2 weeks after he had started treatment with lamotrigine. He had a fever (39.6 degrees C), elevated liver enzymes and atypical lymphocytes in the peripheral blood. This undoubtedly reflects a case of Stevens-Johnson syndrome induced by lamotrigine, but it can also fulfill the criteria of anticonvulsant hypersensitivity syndrome or drug rash with eosinophilia and systemic signs. A case that precisely fits the definition of two syndromes that have different characteristics, different treatments and different prognoses indicates that there is a flaw in the classification.
一名43岁男性在开始服用拉莫三嗪治疗2周后，出现了以史蒂文斯-约翰逊综合征典型的“水疱性斑疹”为特征的皮肤疹，以及嘴唇和颊黏膜糜烂。他发热（39.6摄氏度），肝酶升高，外周血出现非典型淋巴细胞。这无疑是一例由拉莫三嗪诱发的史蒂文斯-约翰逊综合征，但它也符合抗惊厥药超敏反应综合征或伴有嗜酸性粒细胞增多和全身症状的药疹的标准。一个病例精确符合两种具有不同特征、不同治疗方法和不同预后的综合征的定义，这表明分类存在缺陷。
