Qadir Syed Nurul Rasool, Raza Naeem, Qadir Fozi
Department of Dermatology, Combined Military Hospital, Kohat-75200, Pakistan.
Cases J. 2009 Sep 9;2:7765. doi: 10.4076/1757-1626-2-7765.
Among the various drug induced dermatological entities toxic epidermal necrolysis and Stevens-Johnson's syndrome occupy a primary place in terms of mortality. Prompt recognition of these conditions, immediate drug withdrawal and institution of appropriate treatment plays a vital role in reducing mortality. Drugs are by far the most common cause of toxic epidermal necrolysis, in which large sheets of skin are lost from the body surface making redundant the barrier function of the skin, with its resultant complications. The use of systemic corticosteroids in the treatment of toxic epidermal necrolysis has always been controversial, some consider corticosteroids life-saving while others believe that they increase mortality.
We describe two cases of drug-induced toxic epidermal necrolysis, a male and a female, both caucasoids of Pakistani origin, one treated without any steroids and the other with them, who made complete recovery without any major complications or sequelae.
The administration of systemic corticosteriods did not cause any major changes in outcome in our cases.
在各种药物引起的皮肤病中,中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征在死亡率方面占据首要位置。迅速识别这些病症、立即停药并采取适当治疗对于降低死亡率起着至关重要的作用。药物是中毒性表皮坏死松解症最常见的病因,在该病中,体表大片皮肤缺失,使皮肤的屏障功能丧失,进而引发各种并发症。在中毒性表皮坏死松解症的治疗中使用全身性皮质类固醇一直存在争议,一些人认为皮质类固醇能挽救生命,而另一些人则认为它们会增加死亡率。
我们描述了两例药物性中毒性表皮坏死松解症病例,一男一女,均为祖籍巴基斯坦的白种人,一例未使用任何类固醇进行治疗,另一例使用了类固醇,两例均完全康复,未出现任何严重并发症或后遗症。
在我们的病例中,全身性皮质类固醇的使用并未导致结果出现任何重大变化。