Dokumentationszentrum schwerer Hautreaktionen (dZh), Department of Dermatology, Medical Center - University of Freiburg, Hauptstrasse 7, DE-79104 Freiburg, Germany.
Acta Derm Venereol. 2020 Feb 12;100(5):adv00057. doi: 10.2340/00015555-3408.
Bullous drug eruptions are infrequent, but because they pose a challenge both to affected patients and to treating physicians they are considered to be the most severe cutaneous adverse reactions (SCAR). It is important to recognize these conditions and to differentiate them from other clinical entities involving blister formation. There may be early signs and symptoms that indicate a severe bullous drug eruption even before blisters and erosions of the skin and mucous membranes become obvious. Once the diagnosis is suspected, appropriate diagnostic procedures and adequate management must be initiated. The latter includes identification of the potentially inducing drug, although it should be taken into account that not all cases of bullous eruptions are drug-induced. In cases with drug causality the potentially culprit agent must be withdrawn, while in cases with other aetiology the underlying condition, e.g. an infection, must be treated appropriately. In addition to best supportive care, immunomodulating therapy may be considered.
大疱性药疹较为罕见，但因其不仅对受影响的患者，而且对治疗医生来说都是极具挑战的，所以被认为是最严重的皮肤不良反应（SCAR）。识别这些病症并将其与其他涉及水疱形成的临床实体区分开来非常重要。甚至在皮肤和黏膜出现水疱和糜烂之前，就可能出现早期的体征和症状，表明存在严重的大疱性药疹。一旦怀疑诊断，就必须启动适当的诊断程序和充分的治疗。后者包括确定潜在的致病药物，尽管应该考虑到并非所有大疱性皮疹都是药物引起的。在药物因果关系的情况下，必须停用潜在的致病药物，而在其他病因的情况下，必须适当治疗潜在疾病，例如感染。除了最佳的支持性护理外，还可以考虑免疫调节治疗。
