Welykyj S, Gradini R, Nakao J, Massa M
Department of Dermatology and Pathology, Loyola University Medical Center, Maywood, Illinois.
J Cutan Pathol. 1990 Apr;17(2):111-6. doi: 10.1111/j.1600-0560.1990.tb00066.x.
Carbamazepine is an important drug used in the management of seizures, trigeminal neuralgia, and chronic pain syndromes. It has been associated with a variety of adverse skin reactions including urticaria, lichenoid eruptions, erythroderma, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. A 39-year-old white male had been started on carbamazepine for intractable pain which resulted from a right foot crush injury. Approximately 3 months after the start of therapy, the patient had developed a generalized skin eruption following an entire day of sun exposure. Skin biopsies revealed an atypical lymphoid infiltrate in the dermis with collections of the atypical lymphocytes within spongiotic vesicles in the epidermis, suggestive of mycosis fungoides. The patient was treated with systemic prednisone. Subsequent biopsies failed to reveal atypical lymphocytes. Previous reports have described spongiotic eruptions with foci of atypical lymphocytes in contact dermatitis and in patients treated with phenytoin. To the best of our knowledge, this is the first reported case of a carbamazepine-induced eruption simulating mycosis fungoides histologically.
卡马西平是一种用于治疗癫痫、三叉神经痛和慢性疼痛综合征的重要药物。它与多种皮肤不良反应有关，包括荨麻疹、苔藓样疹、红皮病、多形红斑、史蒂文斯 - 约翰逊综合征和中毒性表皮坏死松解症。一名39岁的白人男性因右脚挤压伤导致顽固性疼痛而开始服用卡马西平。在治疗开始约3个月后，患者在一整天的日晒后出现全身性皮疹。皮肤活检显示真皮中有非典型淋巴细胞浸润，表皮海绵状水疱内有非典型淋巴细胞聚集，提示蕈样肉芽肿。该患者接受了全身性泼尼松治疗。随后的活检未发现非典型淋巴细胞。既往报道曾描述过接触性皮炎患者以及接受苯妥英治疗的患者出现伴有非典型淋巴细胞灶的海绵状皮疹。据我们所知，这是首例在组织学上模拟蕈样肉芽肿的卡马西平诱发皮疹的报道病例。
