Department of Dermatology, Faculty of Medicine, Oita University, Yufu City, Japan.
J Dermatol. 2013 Feb;40(2):118-22. doi: 10.1111/1346-8138.12028. Epub 2012 Dec 6.
Drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe reaction usually associated with maculopapular eruptions and systemic involvement. Here we report the first case, to our knowledge, of DIHS/DRESS due to carbamazepine with acute generalized pustular bacterid-like (AGPB-like) eruptions and skeletal muscle involvement. Reviewing our case and the published work, we discuss pustular-type DIHS/DRESS which, in most cases, involves acute generalized exanthematous pustulosis (AGEP)-like skin eruptions in response to carbamazepine. Pustular eruptions may appear in relatively few cases of DIHS/DRESS, in particular, when the causative drug is carbamazepine and, even in cases of intractable pustular bacterid-like eruptions, a reaction to a drug should be suspected. Skeletal muscle involvement may be associated with DIHS/DRESS as one of its systemic manifestations.
药物诱导的超敏反应综合征（DIHS）/伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）是一种严重的反应，通常与斑丘疹和全身受累有关。在这里，我们报告了首例卡马西平引起的伴有急性泛发性脓疱病样（AGPB 样）发疹和骨骼肌受累的 DIHS/DRESS。通过回顾我们的病例和已发表的文献，我们讨论了脓疱型 DIHS/DRESS，在大多数情况下，它是由卡马西平引起的急性泛发性发疹性脓疱病样（AGEP）样皮肤发疹。在脓疱型 DIHS/DRESS 中，脓疱样发疹相对较少见，特别是当致病药物是卡马西平时，即使在难治性脓疱病样发疹的情况下，也应怀疑是药物引起的反应。骨骼肌受累可能是 DIHS/DRESS 的全身表现之一。
