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药物相关的史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症:综述

Drug-related Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review.

作者信息

Arora Rohini, Pande Rajesh K, Panwar Shikha, Gupta Vivek

机构信息

Department of Critical Care, D BL Kapur Superspeciality Hospital, New Delhi, India.

Department of Pharmacology, D BL Kapur Superspeciality Hospital, New Delhi, India.

出版信息

Indian J Crit Care Med. 2021 May;25(5):575-579. doi: 10.5005/jp-journals-10071-23826.

Abstract

INTRODUCTION

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening, allergic reactions affecting the skin and mucous membranes. SJS is considered to be a milder form with less than 10% of body surface area (BSA) involvement. We report successful management of two cases of SJS and TEN. Firstly, a case of a 24-year-old female who presented with rashes over face, chest, and upper limbs after the oral intake of ciprofloxacin and local application of moxifloxacin eye drops. She developed high-grade fever and difficulty in breathing requiring intubation and lung-protective mechanical ventilation and was treated with high-dose methylprednisolone, azithromycin, soframycin skin dressings, and topical ocular antibiotics. Secondly, another case of a 16-year-old female who developed bullous eruptions over the trunk, arms, hands, face, and sole involving 60% of BSA, after oral intake of albendazole. She was diagnosed as TEN and successfully managed with sterile silver nitrate, soframycin dressings, and antibiotics.

KEY MESSAGE

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening, allergic reactions affecting the skin and mucous membranes. Early identification, withdrawal of the suspected drug, and early transfer to a specialized center decrease mortality.

HOW TO CITE THIS ARTICLE

Arora R, Pande RK, Panwar S, Gupta V. Drug-related Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review. Indian J Crit Care Med 2021;25(5):575-579.

摘要

引言

史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)是罕见的、危及生命的、影响皮肤和黏膜的过敏反应。SJS被认为是一种较轻的形式,累及体表面积(BSA)不到10%。我们报告了两例SJS和TEN的成功治疗病例。首先,一名24岁女性在口服环丙沙星并局部应用莫西沙星滴眼液后,面部、胸部和上肢出现皮疹。她出现高热和呼吸困难,需要插管及肺保护性机械通气,并接受了大剂量甲泼尼龙、阿奇霉素、索氟沙星皮肤敷料和局部眼部抗生素治疗。其次,另一名16岁女性在口服阿苯达唑后,躯干、手臂、手部、面部和足底出现大疱性皮疹,累及60%的BSA。她被诊断为TEN,并通过无菌硝酸银、索氟沙星敷料和抗生素成功治疗。

关键信息

史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)是危及生命的、影响皮肤和黏膜的过敏反应。早期识别、停用可疑药物并尽早转至专科中心可降低死亡率。

如何引用本文

Arora R, Pande RK, Panwar S, Gupta V. Drug-related Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review. Indian J Crit Care Med 2021;25(5):575-579.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a056/8196388/3d02b162c060/ijccm-25-575-g001.jpg

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