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鉴别大疱性固定型药疹与史蒂文斯-约翰逊综合征的临床线索:病例报告

Clinical cues for distinguishing bullous fixed drug eruption from Stevens-Johnson syndrome: A case report.

作者信息

Samman Luna, Fernandez Chloe, Dukharan Victoria, Dominguez Patrick

机构信息

Garnet Health Medical Center, Middletown, NY, USA.

Department of Dermatology, KCU-GME Consortium/Advanced Dermatology and Cosmetic Surgery, Orlando, FL, USA.

出版信息

SAGE Open Med Case Rep. 2024 Dec 23;12:2050313X241307117. doi: 10.1177/2050313X241307117. eCollection 2024.

DOI:10.1177/2050313X241307117
PMID:39717689
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11664546/
Abstract

This case report discusses two clinical encounters of a 62-year-old Hispanic woman initially hospitalized with suspected Stevens-Johnson syndrome, later correctly diagnosed with bullous fixed drug eruption during an outpatient visit for a similar eruption. The first encounter involved an extensive evaluation and an 11-day hospital stay, while the second was managed successfully as an outpatient with oral prednisone. This report highlights the importance of differentiating bullous fixed drug eruption from Stevens-Johnson syndrome/toxic epidermal necrolysis and emphasizes the need for a collaborative approach between Primary Care Providers and Dermatology to ensure optimal patient care.

摘要

本病例报告讨论了一名62岁西班牙裔女性的两次临床就诊情况。该患者最初因疑似史蒂文斯-约翰逊综合征住院,后来在门诊就诊时因类似皮疹被正确诊断为大疱性固定性药疹。第一次就诊涉及全面评估和11天的住院治疗,第二次则作为门诊患者成功使用口服泼尼松进行治疗。本报告强调了区分大疱性固定性药疹与史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症的重要性,并强调了初级保健提供者和皮肤科之间采取协作方法以确保为患者提供最佳护理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4932/11664546/3cf200445d82/10.1177_2050313X241307117-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4932/11664546/34a1d7b649ab/10.1177_2050313X241307117-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4932/11664546/3cf200445d82/10.1177_2050313X241307117-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4932/11664546/34a1d7b649ab/10.1177_2050313X241307117-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4932/11664546/3cf200445d82/10.1177_2050313X241307117-fig2.jpg

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本文引用的文献

1
Generalized Bullous Fixed Drug Eruption to Iodinated Contrast Media in Skin of Color.
Am J Med. 2022 Nov;135(11):1326-1329. doi: 10.1016/j.amjmed.2022.07.010. Epub 2022 Jul 25.
2
A Review of Fixed Drug Eruption with a Special Focus on Generalized Bullous Fixed Drug Eruption.固定型药物疹的综述,重点关注全身性大疱性固定型药物疹。
Medicina (Kaunas). 2021 Sep 1;57(9):925. doi: 10.3390/medicina57090925.
3
Contrast-induced generalized bullous fixed drug eruption resembling Stevens-Johnson syndrome.对比剂诱发的类似史蒂文斯-约翰逊综合征的全身性大疱性固定性药疹。
Proc (Bayl Univ Med Cent). 2019 Aug 7;32(4):601-602. doi: 10.1080/08998280.2019.1644147. eCollection 2019 Oct.
4
Bullous fixed drug eruption masquerading as recurrent Stevens Johnson syndrome.伪装成复发性史蒂文斯-约翰逊综合征的大疱性固定性药疹。
J Emerg Med. 2015 May;48(5):551-4. doi: 10.1016/j.jemermed.2014.09.049. Epub 2014 Nov 27.