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多形红斑与史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症:临床表现细微差异,治疗方法差异巨大。

Erythema Multiforme Versus Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: Subtle Difference in Presentation, Major Difference in Management.

作者信息

Newkirk Russell E, Fomin Daren A, Braden Mary M

机构信息

School of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda MD 20814.

Department of Dermatology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda MD 20889.

出版信息

Mil Med. 2020 Sep 18;185(9-10):e1847-e1850. doi: 10.1093/milmed/usaa029.

Abstract

Erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis are immune-mediated epidermal conditions with variable clinical presentations. Although their clinical presentations often overlap, they have distinct etiologies and potential outcomes, which necessitate specific management strategies. This case is presented to highlight the subtle differences and review management given that Stevens-Johnson syndrome/toxic epidermal necrolysis can rapidly become life-threatening. The need for astute diagnostic work-up and accuracy is magnified in the military setting given operations in austere environments and availability of medical and medical evacuation resources. Herein, we present a less common case of bullous erythema-multiforme, the diagnostic approach, and clinical differential with special attention to the importance of the military physician.

摘要

多形红斑和史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症是具有多种临床表现的免疫介导性表皮疾病。尽管它们的临床表现常常重叠,但病因和潜在后果各不相同,这就需要特定的管理策略。鉴于史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症可能迅速危及生命,现展示此病例以突出细微差异并回顾管理方法。鉴于在 austere 环境中的行动以及医疗和医疗后送资源的可用性,在军事环境中敏锐诊断检查和准确性的需求更加迫切。在此,我们呈现一例少见的大疱性多形红斑病例、诊断方法以及临床鉴别诊断,并特别关注军事医生的重要性。

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