Schmidt-Westhausen A, Grünewald T, Reichart P A, Pohle H D
Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Universitätsklinikum Charité, Humboldt Universität zu Berlin, Germany.
Oral Dis. 1998 Jun;4(2):90-4. doi: 10.1111/j.1601-0825.1998.tb00263.x.
To describe oral findings in HIV-infected individuals with toxic epidermal necrolysis (TEN).
In a retrospective study over a 10 year period the medical histories of 931 hospitalised HIV-infected patients were reviewed for the occurrence of TEN.
Five cases of TEN were diagnosed (three men, two women; median age: 41 years; median CD4+ T lymphocyte count: 20/microliter). Four patients had been treated with biweekly pyrimethamine/sulfadoxine for prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis. In one patient flucloxacillin was administered. Signs of TEN with cutaneous epidermolysis occurred and patients showed oral lesions characterized as oropharyngeal blisters and bullae on the palate, buccal mucosa, tongue and floor of the mouth initially. Antibiotics and corticosteroids were administered; none of the patients died.
Longacting sulfonamides and antibiotics have been implicated as the cause of severe mucocutaneous reactions. Since rash and oral blisters may be the first signs of TEN in patients receiving these it is mandatory to follow up these patients closely to detect oral or cutaneous changes indicating the development of TEN.
描述感染人类免疫缺陷病毒（HIV）且患有中毒性表皮坏死松解症（TEN）患者的口腔表现。
在一项为期10年的回顾性研究中，对931例住院的HIV感染患者的病史进行了回顾，以了解TEN的发生情况。
确诊5例TEN患者（3例男性，2例女性；中位年龄：41岁；中位CD4 + T淋巴细胞计数：20/微升）。4例患者接受了每两周一次的乙胺嘧啶/磺胺多辛治疗，以预防卡氏肺孢子虫肺炎和弓形虫病。1例患者使用了氟氯西林。出现了伴有皮肤表皮松解的TEN体征，患者最初表现为口腔病变，特征为口咽水疱以及腭部、颊黏膜、舌部和口底出现大疱。给予了抗生素和皮质类固醇治疗；所有患者均未死亡。
长效磺胺类药物和抗生素被认为是严重皮肤黏膜反应的病因。由于皮疹和口腔水疱可能是接受这些药物治疗的患者发生TEN的首发体征，因此必须对这些患者进行密切随访，以发现提示TEN发展的口腔或皮肤变化。
