Delattre J Y, Safai B, Posner J B
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY.
Neurology. 1988 Feb;38(2):194-8. doi: 10.1212/wnl.38.2.194.
In 15 months we encountered eight patients with intracranial tumors who developed erythema multiforme (EM) or erythema multiforme bullosa (Stevens-Johnson syndrome). All occurred shortly after use of phenytoin (DPH) and brain radiation therapy (WBRT). The clinical picture differed from the classic form of EM in that the erythema began on the scalp and spread to the extremities, progressing in three cases to extensive bullous formation. There were no cases of EM among patients who received either DPH or radiotherapy alone. The combination of DPH, WBRT, and tapering of steroids seems to predispose to EM. The pathogenesis of the disorder is probably immunologic. In the absence of seizures, anticonvulsants should not be given routinely to patients with brain tumors. When anticonvulsants are necessary in patients scheduled for WBRT, DPH may not be the drug of choice.
在15个月的时间里，我们遇到了8例颅内肿瘤患者，他们出现了多形红斑（EM）或大疱性多形红斑（史蒂文斯-约翰逊综合征）。所有病例均在使用苯妥英钠（DPH）和全脑放射治疗（WBRT）后不久发生。临床表现与经典的EM形式不同，红斑始于头皮并蔓延至四肢，3例进展为广泛的水疱形成。单独接受DPH或放疗的患者中没有EM病例。DPH、WBRT和逐渐减少类固醇的联合使用似乎易引发EM。该疾病的发病机制可能是免疫性的。在没有癫痫发作的情况下，脑肿瘤患者不应常规给予抗惊厥药。当计划进行WBRT的患者需要使用抗惊厥药时，DPH可能不是首选药物。
