Huang Li-Yen, Liao Wen-Chang, Chiou Chien-Chun, Lou Jenn-Ping, Hu Philip, Ko Fu-Chang
Intensive Care Unit, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan.
J Formos Med Assoc. 2007 Dec;106(12):1032-7. doi: 10.1016/S0929-6646(08)60079-0.
Toxic epidermal necrolysis (TEN) is a rare but life-threatening skin disease that is most commonly drug-induced. It has recently been suggested that Stevens-Johnson syndrome (SJS) belongs to the same group of skin disorders, although it has a lower mortality rate than TEN. We report the case of a 26-year-old male schizophrenic patient with a history of carbamazepine-induced SJS 5 years earlier. At the time of his current admission, he was admitted to our psychiatry department with acute agitation due to schizophrenia. However, the patient and his family denied history of drug allergy. After 3 days of carbamazepine treatment, the patient developed TEN (body surface area > 90%). He was transferred to the burn center, but despite appropriate treatment, including intravenous hydrocortisone 200 mg q6h and being covered with sterile biological material, he died. It is important to note that re-administration of a drug that previously caused SJS may lead to TEN, which has a very high mortality rate.
中毒性表皮坏死松解症（TEN）是一种罕见但危及生命的皮肤病，最常见由药物引起。最近有人提出，史蒂文斯-约翰逊综合征（SJS）属于同一类皮肤疾病，尽管其死亡率低于TEN。我们报告一例26岁男性精神分裂症患者，5年前有卡马西平诱发SJS的病史。此次入院时，他因精神分裂症急性激越入住我们的精神科。然而，患者及其家属否认有药物过敏史。卡马西平治疗3天后，患者发展为TEN（体表面积>90%）。他被转至烧伤中心，但尽管接受了适当治疗，包括静脉注射氢化可的松200毫克每6小时一次，并覆盖无菌生物材料，他还是死亡了。需要注意的是，重新使用先前引起SJS的药物可能会导致TEN，而TEN的死亡率非常高。
