Sharma V K, Dhar S
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Dermatol. 1995 Jun;12(2):178-83. doi: 10.1111/j.1525-1470.1995.tb00149.x.
Various types of cutaneous drug eruptions and the incriminating drugs were analyzed in 50 children and adolescents up to 18 years of age (34 or 65% boys, 16 or 32% girls). Thirteen (26%) patients had a maculopapular rash, 11 (22%) a fixed drug eruption (FDE), 10 erythema multiforme (EM), 6 (12%) toxic epidermal necrolysis (TEN), 5 (10%) Stevens-Johnson syndrome (SJS), 3 (6%) urticaria, and 2 (4%) erythroderma. The incubation period for maculopapular rashes, SJS and TEN due to commonly used antibiotics and sulfonamides was short, a few hours to two to three days, reflecting reexposure, and for drugs used sparingly such as antiepileptics and antituberculosis agents, was approximately one week or more, suggesting a first exposure. Antibiotics were responsible for cutaneous eruptions in 27 patients, followed by antiepileptics in 17, analgin in 4, and metronidazole and albendazole in 1 each. Cotrimoxazole, a combination of sulfamethoxazole and trimethoprim, was the most common antibacterial responsible for eruptions (11 patients), followed by penicillin and its semisynthetic derivatives (8 patients), sulfonamide alone (3 patients), and other antibiotics (4 patients). Antiepileptics were the most frequently incriminated drugs in EM, TEN, and SJS. The role of systemic corticosteroids in the management of SJS and TEN is controversial. We administered prednisolone or an equivalent corticosteroid 2 mg/kg/day for 7 to 14 days.(ABSTRACT TRUNCATED AT 250 WORDS)
对50名18岁及以下儿童和青少年（34名或65%为男孩，16名或32%为女孩）的各类皮肤药物疹及相关药物进行了分析。13名（26%）患者出现斑丘疹，11名（22%）出现固定性药疹（FDE），10名出现多形红斑（EM），6名（12%）出现中毒性表皮坏死松解症（TEN），5名（10%）出现史蒂文斯-约翰逊综合征（SJS），3名（6%）出现荨麻疹，2名（4%）出现红皮病。常用抗生素和磺胺类药物引起的斑丘疹、SJS和TEN的潜伏期较短，为数小时至两到三天，反映为再次接触，而如抗癫痫药和抗结核药等使用较少的药物，潜伏期约为一周或更长，提示为首次接触。27名患者的皮肤疹由抗生素引起，其次是17名由抗癫痫药引起，4名由安乃近引起，各有1名由甲硝唑和阿苯达唑引起。复方新诺明（磺胺甲恶唑和甲氧苄啶的组合）是引起皮疹最常见的抗菌药物（11名患者），其次是青霉素及其半合成衍生物（8名患者）、单独的磺胺类药物（3名患者）和其他抗生素（4名患者）。抗癫痫药是EM、TEN和SJS中最常涉及的药物。全身性皮质类固醇在SJS和TEN治疗中的作用存在争议。我们给予泼尼松龙或等效皮质类固醇2mg/kg/天，持续7至14天。（摘要截取自250字）
