van Zogchel L, Hendriks T, Adriaens S, Diederen I, Herremans E
Huisartsenpraktijk Nederweert, Nederweert.
Ned Tijdschr Geneeskd. 2016;160:D470.
Fixed drug eruption is a hypersensitive skin response to drugs, which can present itself in different ways. The skin lesions are usually solitary, but can also appear as a maculopapular rash, Stevens-Johnson syndrome or toxic epidermal necrolysis. While fixed drug eruptions can be caused by various drugs, paracetamol is responsible in 1.5% of cases.
A 58-year-old man was seen in general practice with a five-year-old exanthema on his torso, arms and legs. A biopsy from one of the lesions revealed a fixed drug eruption. When asked, the patient admitted using paracetamol for the last five years on a near-daily basis to ease headaches. After cessation of paracetamol, the exanthema gradually disappeared.
It continues to be important to ask patients with a rash of unclear origin about the use of any medicines. Particularly over-the-counter drugs with relatively few side-effects, such as paracetamol, should be considered.
固定性药疹是皮肤对药物的一种超敏反应,可表现为不同形式。皮肤损害通常为单发,但也可表现为斑丘疹、史蒂文斯 - 约翰逊综合征或中毒性表皮坏死松解症。虽然多种药物均可引起固定性药疹,但对乙酰氨基酚在1.5%的病例中是病因。
一名58岁男性因躯干、手臂和腿部出现五年之久的皮疹前来全科医疗就诊。对其中一处皮疹进行活检显示为固定性药疹。经询问,患者承认在过去五年中几乎每天都服用对乙酰氨基酚以缓解头痛。停用对乙酰氨基酚后,皮疹逐渐消退。
对于皮疹病因不明的患者,询问其用药情况仍然很重要。应考虑到那些副作用相对较少的非处方药,如对乙酰氨基酚。