Chen Ning, Li Miao
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pediatr. 2022 Mar 3;10:823376. doi: 10.3389/fped.2022.823376. eCollection 2022.
-induced rash and mucositis (MIRM) is a rare disease, which has not been reported in northern China previously. We retrospectively analyzed the clinical characteristics, diagnosis and treatment of 10 cases of MIRM in order to help clinicians to identify MIRM and to distinguish it from the similar mucositis and cutaneous characteristics of Stevens-Johnson syndrome. All 10 children included in the study had MIRM with skin and mucosal symptoms, but the characteristics of the skin and mucosal lesions differed by age. Most of the older children had sparse erythema and a vesicular rash, but the younger children had dense erythema without blisters but with purulent exudation. The mucositis was relatively mild in the younger children. The erythrocyte sedimentation rate, the levels of C-reactive protein, lactate dehydrogenase, and D-dimer were significantly elevated in most children with MIRM. Concomitant treatment of glucocorticoids and/or IVIG with macrolides may shorten the duration of fever and accelerate the clinical recovery. Additional case reports are needed to improve knowledge of the characteristics of MIRM and its response to therapy.
诱导性皮疹和粘膜炎(MIRM)是一种罕见疾病,此前在中国北方尚未见报道。我们回顾性分析了10例MIRM患者的临床特征、诊断和治疗情况,以帮助临床医生识别MIRM,并将其与史蒂文斯-约翰逊综合征相似的粘膜炎和皮肤特征相区分。纳入研究的所有10名儿童均患有伴有皮肤和黏膜症状的MIRM,但皮肤和黏膜病变的特征因年龄而异。大多数年龄较大的儿童有稀疏红斑和水疱性皮疹,而年龄较小的儿童有密集红斑,无水泡但有脓性渗出物。年龄较小的儿童粘膜炎相对较轻。大多数MIRM患儿的红细胞沉降率、C反应蛋白、乳酸脱氢酶和D-二聚体水平显著升高。糖皮质激素和/或静脉注射免疫球蛋白联合大环内酯类药物治疗可能会缩短发热持续时间并加速临床康复。需要更多的病例报告来提高对MIRM特征及其治疗反应的认识。