Jouhar Lamia, Yahya Marva, Elsiddiq Sohair
Department of Pediatrics Hamad Medical Corporation Doha Qatar.
Clin Case Rep. 2022 Mar 13;10(3):e05565. doi: 10.1002/ccr3.5565. eCollection 2022 Mar.
Toxic Epidermal Necrolysis/Steven-Johnson Syndrome (TEN/SJS) is one of the most serious dermatological adverse reactions triggered mainly by drugs and less likely by infections. COVID-19 disease is caused by Sever Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with a wide range of clinical manifestations. Skin involvement is common in COVID-19 patients including urticaria, purpura, and vasculitis. There were reported cases of TEN/SJS in adults with COVID-19 infections and only two reported cases in pediatric patients. The causality relationship between COVID-19 infection and TEN/SJS was not established in most cases due to history of drug usage that could be the trigger. In this study, we are reporting a case of previously healthy child apart from COVID-19 infection who was admitted to the intensive care unit with TEN involving more than 30% of body surface area confirmed by skin biopsy. The child was treated with intravenous immunoglobulins, steroids, and cyclosporin with a very good outcome.
中毒性表皮坏死松解症/史蒂文斯-约翰逊综合征(TEN/SJS)是最严重的皮肤科不良反应之一,主要由药物引发,感染引发的可能性较小。新型冠状病毒肺炎(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,临床表现多样。皮肤受累在COVID-19患者中很常见,包括荨麻疹、紫癜和血管炎。有成人COVID-19感染合并TEN/SJS的病例报道,而儿科患者仅有两例报道。由于可能作为触发因素的用药史,大多数情况下未确立COVID-19感染与TEN/SJS之间的因果关系。在本研究中,我们报告了一例既往健康的儿童,除感染COVID-19外,因TEN入住重症监护病房,皮肤活检证实体表面积受累超过30%。该患儿接受了静脉注射免疫球蛋白、类固醇和环孢素治疗,效果良好。