Sevketoglu Esra, Hatipoglu Sami, Akman Mustafa, Bicer Suat
Department of Pediatrics, Bakirkoy Dr Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
Pediatr Emerg Care. 2009 Feb;25(2):93-5. doi: 10.1097/PEC.0b013e318196eac4.
Toxic epidermal necrolysis is an uncommon but potentially life-threatening skin reaction that is frequently induced by drugs. The mucocutaneous reaction is characterized by bullous detachment of the epidermis and mucous membranes. We report a case of toxic epidermal necrolysis in a child receiving carbamazepine for 3 weeks; 60% of his body surface area was affected with mucosal involvement of the oropharynx, eyes, gastrointestinal system, and genitalia. His skin signs appeared 1 day after the last dosage increment. He was successfully treated with intravenous immunoglobulin and appropriate infection and wound management. The key to successful outcome includes early recognition, transfer to an intensive care center, prompt withdrawal of the causative agent, appropriate fluid resuscitation, and infection monitoring.
中毒性表皮坏死松解症是一种罕见但可能危及生命的皮肤反应，常由药物引起。其皮肤黏膜反应的特征为表皮和黏膜的大疱性剥脱。我们报告一例接受卡马西平治疗3周的儿童发生中毒性表皮坏死松解症的病例；其体表面积的60%受到影响，口咽、眼睛、胃肠道系统和生殖器均有黏膜受累。其皮肤症状在最后一次增加剂量1天后出现。他通过静脉注射免疫球蛋白以及适当的感染和伤口处理得到了成功治疗。成功治疗的关键包括早期识别、转至重症监护中心、迅速停用致病药物、适当的液体复苏以及感染监测。
