儿童重症多形性红斑和Stevens-Johnson综合征临床对比研究

为比较儿童重症多形性红斑(EMM)和Stevens-Johnson综合征(SJS)临床特点和发病诱因,回顾分析了32例EMM和21例SJS住院患者的临床资料。结果：EMM组患病年龄较SJS小,SJS发热比率、粘膜受累和并发症均显著高于EMM;EMM组患儿有明确感染病史者占50％,SJS仅3．12％;而SJS组与药物明确相关者17／21例,EMM仅3／21例。提示可以从皮损表现上鉴别SJS和EMM;SJS粘膜和内脏损害更重;感染和药物分别在EMM和SJS发病中起主要作用。

A comparative study on children with erythema multiforme majus and Stevens-Johnson syndrome

To compare the clinical characteristics and the inducing factors in children with erythema multiforme majus(EMM) and Stevens-Johnson syndrome (SJS), the clinical data of 53 children admitted between 1988 and 2003 were retrospectively reviewed including 32 children with EMM and 21 with SJS. The results showed that the age of initial presentation in EMM patients was younger than that in SJS patients while the proportion for fever, mucus membrane involvement and the complications were significantly higher in SJS patients than that in EMM patients. 50% of EMM patients had a clear history of infection, but only 3.21% in SJS patients, 17 of 21 children with SJS had clearly association with the drugs, while only 3(3/21) children with EMM had such association, indicating that SJS can be differentiated from EMM according to the presentation patterns of the skin lesions, more severe mucus membrane and organs damage could be found in children with SJS. Infection and drugs respectively played a very important role in the pathogenesis of the children with EMM and SJS.