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一名有色人种患者的史蒂文斯-约翰逊综合征:病例报告及医学教育资源多样性评估

Stevens-Johnson Syndrome in a Patient of Color: A Case Report and an Assessment of Diversity in Medical Education Resources.

作者信息

Diep Darlene, Aluri Bineetha, Crane Alison, Miao Kathleen, Kannan Kamilah S, Goldsteen Robert

机构信息

Medicine, Burrell College of Osteopathic Medicine, Las Cruces, USA.

Medicine, University of Southern California, Los Angeles, USA.

出版信息

Cureus. 2022 Feb 15;14(2):e22245. doi: 10.7759/cureus.22245. eCollection 2022 Feb.

Abstract

This is a review of a patient encounter that underscores the common trend of insufficient inclusivity and lack of diversity regarding skin of color representation in teaching materials including textbooks in the medical education setup. A Black woman who was treated with carbamazepine for trigeminal neuralgia after a dental procedure presented with upper airway breathing difficulties and facial pain and swelling. After doubling her dose of carbamazepine as advised by her primary care physician, her symptoms continued to worsen, and she was treated in the emergency department for a presumed allergic reaction of unknown etiology. Two days later, her symptoms progressively worsened. She self-admitted to the emergency department, where she required cardiopulmonary resuscitation. Eventually, the formal diagnosis of carbamazepine-induced Stevens-Johnson syndrome (SJS) was made based on history, clinical presentation, and skin biopsy. The nature of the disease progression in this case prompted our investigation into the lack of representation of skin of color in current medical training resources regarding SJS. Our assessment demonstrates that there is a significant underrepresentation of SJS in skin of color in medical educational resources. Increased inclusivity of skin disorders in patients of color is crucial in training healthcare professionals to recognize life-threatening cutaneous disorders quickly and accurately in such patients.

摘要

这是一次患者诊疗经历的回顾,它突显了医学教育机构中教材(包括教科书)在涉及有色人种皮肤表现方面普遍存在的包容性不足和缺乏多样性的问题。一名黑人女性在牙科手术后因三叉神经痛接受卡马西平治疗,出现了上呼吸道呼吸困难、面部疼痛和肿胀。在其初级保健医生建议下将卡马西平剂量加倍后,她的症状持续恶化,因疑似病因不明的过敏反应在急诊科接受治疗。两天后,她的症状逐渐加重。她自行前往急诊科,在那里需要进行心肺复苏。最终,根据病史、临床表现和皮肤活检做出了卡马西平诱发的史蒂文斯 - 约翰逊综合征(SJS)的正式诊断。该病例中疾病进展的性质促使我们调查当前医学培训资源中关于SJS在有色人种皮肤方面的表现情况。我们的评估表明,医学教育资源中SJS在有色人种皮肤方面的呈现明显不足。增加对有色人种患者皮肤疾病的包容性对于培训医疗保健专业人员快速准确识别此类患者中危及生命的皮肤疾病至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e3a/8929762/f8ccc38506ec/cureus-0014-00000022245-i01.jpg

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