Lee Sang Sin, Hong Dong Kyun, Im Myung, Lee Young, Seo Young Joon, Lee Jeung Hoon
Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea.
Ann Dermatol. 2011 Dec;23(Suppl 3):S383-6. doi: 10.5021/ad.2011.23.S3.S383. Epub 2011 Dec 27.
The principles determining the primary localization of lesions in fixed drug eruption (FDE) are still unknown. Studies investigating the predilection areas in FDE have indicated drug-related, trauma-related, or inflammation-related specific site involvement, as well as visceracutaneous reflex-related specific site involvement. The importance of viscerocutaneous reflexes for the location of dermatoses was first recognized in the 1960s. Head's zones are viscerocutaneous reflex projection fields on the skin that extend over certain dermatomes and possess a reflex-associated maximal point. Recently, in a Turkish collective of patients, three women with the primary location of FDE lesions on the maximal points of Head's zones were presented. We also experienced 3 cases with FDE where the lesions were located at specific sites (buttocks), the so-called maximal points of Head's zones, which are known to be the most active dermatomal areas of an underlying visceral pathology. An underlying internal disturbance (ureter stone, pyelonephritis and chronic pelvic inflammatory disease) was found in all 3 patients, corresponding to the organ-related maximal point of Head's zones in each case. In conclusion, the primary location of FDE lesions on the maximal points of Head's zones revealed relevant organ disorders with corresponding projection fields.
固定性药疹（FDE）中决定皮损初始定位的机制尚不清楚。关于FDE好发部位的研究表明，其与药物、创伤、炎症或内脏皮肤反射相关的特定部位受累有关。内脏皮肤反射对皮肤病定位的重要性在20世纪60年代首次得到认可。海德带是皮肤内脏皮肤反射投射区，延伸至特定皮节，并有一个反射相关的最大点。最近，在一个土耳其患者群体中，报告了3名女性患者，其FDE皮损初始部位位于海德带的最大点。我们也遇到了3例FDE患者，其皮损位于特定部位（臀部），即所谓的海德带最大点，这些部位是已知的潜在内脏病变最活跃的皮节区域。所有3例患者均发现潜在的内部紊乱（输尿管结石、肾盂肾炎和慢性盆腔炎），分别对应于每种情况下海德带与器官相关的最大点。总之，FDE皮损位于海德带最大点提示了相应投射区的相关器官疾病。
