Revuz J, Penso D, Roujeau J C, Guillaume J C, Payne C R, Wechsler J, Touraine R
Arch Dermatol. 1987 Sep;123(9):1160-5. doi: 10.1001/archderm.123.9.1160.
Eighty-seven patients with toxic epidermal necrolysis were observed at Hôpital Henri Mondor in Créteil, France, over the last 12 years. The mean percentage of body surface area involved was 39%. Erosive mucous membrane lesions, identical to those of Stevens-Johnson syndrome, were present in all but three cases. Necrolysis was sometimes generalized within 24 hours but usually spread progressively after a Stevens-Johnson syndrome-like aspect at the onset. Mortality was 25%. Infection, mainly with Staphylococus aureus and Pseudomonas aeruginosa, was the first cause of death, clearly responsible in ten of 20 cases. Age, extension of necrolysis, idiopathic nature of toxic epidermal necrolysis, ingestion of many drugs, elevation of urea, creatinine, and glucose levels, neutropenia, lymphopenia, and thrombocytopenia were statistically linked to a bad prognosis. A multivariant analysis showed that three of these prognosis factors are of paramount importance, namely: age, area of necrolysis, and serum urea level. Pigmentary changes and sicca syndrome were frequently observed sequelae in survivors.
在过去12年里，法国克雷泰伊的亨利·蒙多医院观察了87例中毒性表皮坏死松解症患者。受累体表面积的平均百分比为39%。除3例患者外，其余患者均出现了与史蒂文斯-约翰逊综合征相同的糜烂性黏膜病变。坏死松解有时在24小时内全身发作，但通常在发病初期出现类似史蒂文斯-约翰逊综合征的表现后逐渐蔓延。死亡率为25%。感染，主要是金黄色葡萄球菌和铜绿假单胞菌感染，是首要死因，在20例死亡病例中有10例明确与之相关。年龄、坏死松解范围、中毒性表皮坏死松解症的特发性、多种药物的摄入、尿素、肌酐和血糖水平升高、中性粒细胞减少、淋巴细胞减少和血小板减少与不良预后在统计学上相关。多变量分析表明，这些预后因素中有三个至关重要，即：年龄、坏死松解面积和血清尿素水平。色素沉着改变和干燥综合征是幸存者中常见的后遗症。
