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氨苯砜超敏反应综合征中的解剖位置异常现象1例

A Case of Anatopic Phenomenon in Dapsone Hypersensitivity Syndrome.

作者信息

Devi S Kartika, Raviprakash Divya, Priyadarshini Anuradha, Sundaram Murugan, S Adikrishnan

机构信息

Dermatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

出版信息

Cureus. 2024 Aug 25;16(8):e67732. doi: 10.7759/cureus.67732. eCollection 2024 Aug.

DOI:10.7759/cureus.67732
PMID:39318907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11421480/
Abstract

We report a case of a 67-year-old woman on multidrug therapy for borderline lepromatous leprosy who developed dapsone hypersensitivity syndrome (DHS). She presented with fever and red pruritic rash over her face, neck, trunk and upper limbs, with distinct sparing of hypopigmented leprosy patches on her trunk. Laboratory findings showed anemia, elevated white blood cell count and liver function abnormalities. Upon discontinuation of dapsone and initiation of intravenous dexamethasone, the reaction subsided. This case report describes anatopic response, a phenomenon where a cutaneous infection modifies the inflammatory response of a secondary inflammatory dermatoses at the same location. We further elucidate the pathogenic mechanisms implicated in anatopic response, a phenomenon not commonly documented in the literature.

摘要

我们报告了一例67岁女性，她因边缘性瘤型麻风接受多药治疗，期间发生了氨苯砜超敏综合征（DHS）。她出现发热，面部、颈部、躯干和上肢出现红色瘙痒皮疹，躯干上色素减退的麻风斑块明显未受累。实验室检查结果显示贫血、白细胞计数升高和肝功能异常。停用氨苯砜并开始静脉注射地塞米松后，反应消退。本病例报告描述了异位反应，即皮肤感染改变同一部位继发性炎性皮肤病炎症反应的现象。我们进一步阐明了异位反应所涉及的致病机制，这是一种文献中不常记载的现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/498d86c2aa86/cureus-0016-00000067732-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/77009b1c965d/cureus-0016-00000067732-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/2a69f6eb05b3/cureus-0016-00000067732-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/498d86c2aa86/cureus-0016-00000067732-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/77009b1c965d/cureus-0016-00000067732-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/2a69f6eb05b3/cureus-0016-00000067732-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e67/11421480/498d86c2aa86/cureus-0016-00000067732-i03.jpg

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Anatopic response: Double sparing phenomenon in a patient with dapsone hypersensitivity syndrome.
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