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牙科诊所环境中史蒂文斯-约翰逊综合征的早期诊断

Early Diagnosis of Stevens-Johnson Syndrome in the Dental Clinic Setting.

作者信息

Al Hathlol Wisam K, Almeslet Asma

机构信息

Department of Pediatric Dentistry, National Guard Hospital, Dammam, SAU.

Oral Maxillofacial Surgery and Diagnosis Department, Riyadh Elm University, Riyadh, SAU.

出版信息

Cureus. 2021 Mar 28;13(3):e14160. doi: 10.7759/cureus.14160.

Abstract

Stevens-Johnson syndrome (SJS) is a life-threatening acute and fatal dermatological disease. It can present with many variations and rapidly worsens in a short period of time. Early diagnosis and management play an important role in stopping SJS from progression. Various drugs such as antibiotics, anticonvulsants and non-steroidal anti-inflammatory drugs can trigger the disease as an adverse effect. Oral and dental manifestation of SJS is uncommon. However, dentists should be clinically oriented towards signs and symptoms of the disease, both oral and systemic. We present a case of a 37-year-old male with no past medical history who presented to the dental emergency clinic complaining of dysphagia and burning sensation in the mouth. On oral examination, oral rash and blisters were observed. In addition, a bilateral forearm erythematous, non-blanching painful rash with some blisters was found after antibiotic administration three days earlier. The antibiotic was stopped and the patient was started on topical betamethasone for 14 days, topical chlorhexidine for 10 days, and oral nystatin suspension 100,000 units. A complete resolution of the oral and systemic manifestation was seen without the need for hospital admission.

摘要

史蒂文斯 - 约翰逊综合征(SJS)是一种危及生命的急性致命性皮肤病。它有多种表现形式,且在短时间内会迅速恶化。早期诊断和治疗对于阻止SJS进展起着重要作用。多种药物如抗生素、抗惊厥药和非甾体抗炎药可作为不良反应引发该疾病。SJS的口腔和牙齿表现并不常见。然而,牙医应从临床角度关注该疾病的体征和症状,包括口腔和全身方面。我们报告一例37岁男性病例,该患者无既往病史,因吞咽困难和口腔烧灼感就诊于牙科急诊诊所。口腔检查时,发现口腔皮疹和水疱。此外,在三天前使用抗生素后,双侧前臂出现红斑、压之不褪色的疼痛性皮疹并有一些水疱。停用抗生素后,患者开始外用倍他米松14天、外用洗必泰10天以及口服制霉菌素混悬液100,000单位。口腔和全身症状完全消退,无需住院治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f00/8078824/fa851a0db725/cureus-0013-00000014160-i01.jpg

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