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戊酸雌二醇片引发罕见严重药疹:首例报道病例

Estradiol Valerate Tablets Caused Rare Severe Drug Eruption: The First Reported Case.

作者信息

Yang Fang, Xu Yuedan, Li Xiangyu

机构信息

Department of Pharmacy, Shaoxing Keqiao Women & Children΄s Hospital, Shaoxing, Zhejiang, People's Republic of China.

出版信息

Clin Cosmet Investig Dermatol. 2024 Oct 14;17:2277-2281. doi: 10.2147/CCID.S495269. eCollection 2024.

DOI:10.2147/CCID.S495269
PMID:39430646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11488355/
Abstract

Severe drug eruption is a severe allergic reaction to a drug, usually due to irritation with certain drugs. It may be present as a generalized erythematous maculopapular rash, a pleomorphic rash, with or without blisters and ulcers. To the best of our knowledgeto date, there is no report of estradiol valerate-induced severe drug eruption. A case of rare severe drug eruption after taking estradiol valerate tablets was first reported to promote clinical drug safety management, especially for rare severe adverse reactions. Meanwhile, it is speculated that estrogen dermatitis might be associated with dendritic cell-mediated allergic mechanisms, inflammation-induced expression of estrogen receptor β, and elevated estrogen levels during pregnancy, according to previous studies. Therefore, pregnant women using this drug need to be focused on. Early and systemic use of glucocorticoids is beneficial to the outcome and prognosis of the disease. It highlights the need for clinicians to be vigilant about rare but serious adverse drug reactions, even with medications that are generally considered safe.

摘要

重症药疹是对药物的一种严重过敏反应,通常由某些药物刺激引起。它可能表现为全身性红斑丘疹、多形性皮疹,伴有或不伴有水疱和溃疡。据我们所知,迄今为止尚无戊酸雌二醇引起重症药疹的报道。首次报道了1例服用戊酸雌二醇片后发生罕见重症药疹的病例,以促进临床药物安全管理,尤其是针对罕见的严重不良反应。同时,根据以往研究推测,雌激素性皮炎可能与树突状细胞介导的过敏机制、炎症诱导的雌激素受体β表达以及孕期雌激素水平升高有关。因此,使用该药物的孕妇需要受到关注。早期全身使用糖皮质激素有利于疾病的转归和预后。这凸显了临床医生即使对通常认为安全的药物也需警惕罕见但严重的药物不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b18/11488355/42158c66ea3f/CCID-17-2277-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b18/11488355/42158c66ea3f/CCID-17-2277-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b18/11488355/42158c66ea3f/CCID-17-2277-g0001.jpg

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本文引用的文献

1
Pharmacokinetics and Safety of Estradiol Valerate Tablet and Its Generic: A Phase 1 Bioequivalence Study in Healthy Chinese Postmenopausal Female Subjects.戊酸雌二醇片及其仿制药的药代动力学和安全性:一项健康中国绝经后女性受试者的 1 期生物等效性研究。
Drug Des Devel Ther. 2024 Jul 10;18:2891-2904. doi: 10.2147/DDDT.S460681. eCollection 2024.
2
Association of Early Systemic Corticosteroid Therapy with Mortality in Patients with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis: A Retrospective Cohort Study Using a Nationwide Claims Database.早期全身皮质类固醇治疗与 Stevens-Johnson 综合征或中毒性表皮坏死松解症患者死亡率的关联:使用全国索赔数据库的回顾性队列研究。
Am J Clin Dermatol. 2019 Aug;20(4):579-592. doi: 10.1007/s40257-019-00443-9.
3
Hydrochlorothizide-induced acute generalised exanthematous pustulosis presenting with bilateral periorbital impetigo.氢氯噻嗪诱发的急性泛发性脓疱性皮病伴双侧眶周脓疱疮。
BMJ Case Rep. 2019 Feb 11;12(2):e223528. doi: 10.1136/bcr-2017-223528.
4
Estrogen dermatitis: Case report and examination of estrogen receptor-β in the skin.雌激素性皮炎:病例报告及皮肤中雌激素受体-β的检测。
J Dermatol. 2019 Mar;46(3):263-266. doi: 10.1111/1346-8138.14750. Epub 2019 Jan 10.
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Acute Generalized Exanthematous Pustulosis Induced by Docetaxel and Recurrent With Letrozole: A Case Report.多西他赛诱导的急性泛发性脓疱性皮病并在来曲唑治疗时复发:一例报告
Clin Breast Cancer. 2018 Oct;18(5):e743-e746. doi: 10.1016/j.clbc.2018.06.009. Epub 2018 Jun 18.
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Fixed drug eruption associated with aspirin.与阿司匹林相关的固定性药疹。
BMJ Case Rep. 2018 Mar 17;2018:bcr-2017-222004. doi: 10.1136/bcr-2017-222004.
7
Two cases of annular acute generalized exanthematous pustulosis induced by terbinafine.两例由特比萘芬引起的环状急性泛发性脓疱性皮病。
Eur J Dermatol. 2018 Apr 1;28(2):236-238. doi: 10.1684/ejd.2017.3199.
8
Suppositories for fever as a major risk for phenobarbital-induced fixed drug eruption in children.用于退热的栓剂是儿童苯巴比妥诱发固定型药疹的主要危险因素。
J Eur Acad Dermatol Venereol. 2017 Oct;31(10):e443-e444. doi: 10.1111/jdv.14261. Epub 2017 Apr 26.
9
A Rare Case of Oestrogen Dermatitis.一例罕见的雌激素性皮炎病例。
J Cutan Med Surg. 2017 May/Jun;21(3):261-262. doi: 10.1177/1203475416685075. Epub 2016 Dec 22.
10
Autoimmune estrogen dermatitis in an infertile female.一名不孕女性的自身免疫性雌激素性皮炎。
Cutan Ocul Toxicol. 2017 Jun;36(2):195-198. doi: 10.1080/15569527.2016.1245197. Epub 2016 Nov 2.