Yarbrough D R
Department of Surgery, Medical University of South Carolina, Charleston 29425, USA.
J Burn Care Rehabil. 1996 Jan-Feb;17(1):30-3. doi: 10.1097/00004630-199601000-00008.
Toxic epidermal necrolysis syndrome is one of several clinically similar, severe acute, exfoliative skin disorders that have become of increasing interest to burn surgeons in recent years. Recognition of a clinical course similar to extensive second-degree burns has resulted in the development of treatment protocols that are best carried out in a burn unit by personnel experienced in critical care techniques, the management of extensive cutaneous injuries, fluid and electrolyte derangements, and intensive nutritional support of critically ill patients. Current evidence suggests that in most instances toxic epidermal necrolysis syndrome is a CD8 lymphocyte-mediated reaction triggered by exposure to certain drugs. The target organs of the immune reaction are skin and mucous membranes. Appropriate management of the extensive skin wounds and the nutritional and critical care support afforded by treatment in burn units appears to have contributed significantly to the increasing survival of patients with this devastating and potentially lethal illness.
中毒性表皮坏死松解症是近年来引起烧伤外科医生越来越多关注的几种临床相似的严重急性剥脱性皮肤病之一。认识到其临床病程与大面积二度烧伤相似，促使制定了治疗方案，这些方案最好在烧伤病房由精通重症护理技术、大面积皮肤损伤管理、液体和电解质紊乱以及重症患者强化营养支持的人员来实施。目前的证据表明，在大多数情况下，中毒性表皮坏死松解症是由接触某些药物引发的CD8淋巴细胞介导的反应。免疫反应的靶器官是皮肤和黏膜。对大面积皮肤伤口的妥善处理以及烧伤病房治疗所提供的营养和重症护理支持，似乎对这种毁灭性且可能致命疾病患者存活率的提高起到了显著作用。
