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神经科药物的皮肤不良反应

Cutaneous Adverse Effects of Neurologic Medications.

作者信息

Bahrani Eman, Nunneley Chloe E, Hsu Sylvia, Kass Joseph S

机构信息

Baylor College of Medicine, Houston, TX, USA.

Department of Dermatology, Baylor College of Medicine, Houston, TX, USA.

出版信息

CNS Drugs. 2016 Mar;30(3):245-67. doi: 10.1007/s40263-016-0318-7.

DOI:10.1007/s40263-016-0318-7
PMID:26914914
Abstract

Life-threatening and benign drug reactions occur frequently in the skin, affecting 8 % of the general population and 2-3 % of all hospitalized patients, emphasizing the need for physicians to effectively recognize and manage patients with drug-induced eruptions. Neurologic medications represent a vast array of drug classes with cutaneous side effects. Approximately 7 % of the United States (US) adult population is affected by adult-onset neurological disorders, reflecting a large number of patients on neurologic drug therapies. This review elucidates the cutaneous reactions associated with medications approved by the US Food and Drug Administration (FDA) to treat the following neurologic pathologies: Alzheimer disease, amyotrophic lateral sclerosis, epilepsy, Huntington disease, migraine, multiple sclerosis, Parkinson disease, and pseudobulbar affect. A search of the literature was performed using the specific FDA-approved drug or drug classes in combination with the terms 'dermatologic,' 'cutaneous,' 'skin,' or 'rash.' Both PubMed and the Cochrane Database of Systematic Reviews were utilized, with side effects ranging from those cited in randomized controlled trials to case reports. It behooves neurologists, dermatologists, and primary care physicians to be aware of the recorded cutaneous adverse reactions and their severity for proper management and potential need to withdraw the offending medication.

摘要

危及生命和良性的药物反应在皮肤中频繁发生,影响着8%的普通人群和2%-3%的住院患者,这凸显了医生有效识别和管理药物性皮疹患者的必要性。神经科药物涵盖了一大类具有皮肤副作用的药物。美国约7%的成年人口受成人期神经系统疾病影响,这意味着大量患者正在接受神经科药物治疗。本综述阐明了与美国食品药品监督管理局(FDA)批准用于治疗以下神经病理疾病的药物相关的皮肤反应:阿尔茨海默病、肌萎缩侧索硬化症、癫痫、亨廷顿病、偏头痛、多发性硬化症、帕金森病和假性延髓情绪障碍。通过使用FDA批准的特定药物或药物类别,并结合“皮肤病学的”“皮肤的”“皮肤”或“皮疹”等术语进行文献检索。同时使用了PubMed和Cochrane系统评价数据库,副作用范围从随机对照试验中引用的到病例报告中的都有。神经科医生、皮肤科医生和初级保健医生有必要了解已记录的皮肤不良反应及其严重程度,以便进行适当管理,并在必要时停用引起不良反应的药物。

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