蛇脂软膏治疗多形红斑疗效观察

我科于1999年1月～2003年3月用蛇脂软膏（广东皮宝制药集团有限公司生产）与肤轻松软膏（山东鲁抗辰欣药业有限公司生产）比较外用治疗多形红斑,取得了满意疗效现报告如下。     

联合治疗32例寒冷性多形红斑疗效观察

1998年 1 1月至 1 2月 ,我们采用脑益嗪、雷公藤、氨苯砜及大剂量维生素Ｅ联合治疗 32例寒冷性多形红斑 ,取得较好疗效 ,兹报告如下 :1　临床资料1 1　一般资料　 32例患者 ,男 1 1例 ,女 2 1例 ,年龄 8至41岁 ,病程三天至二周 ,就诊时首次发病者 2 4例 ,复发者8例。1 2　临床表现　 32例患者均有典型的临床表现 ,符合寒冷性多形红斑诊断标准〔1〕损害对称分布于四肢远端 ,除手背外 ,也常见于掌面。皮疹表现为多形性 ,以水肿性丘疹为主 ,典型损害呈虹膜样红斑 ,中央有水疱、自觉瘙痒 ,局部温度低 ,皮肤发凉。 32例患者上述部位均有发生 4例…     

海普林在多形红斑和结节性红斑治疗中的应用

多形红斑及结节性红斑是皮肤科的常见病和多发病,为了探讨海普林在其外用治疗中的作用,我们应用随机对照的方法对42例多形红斑和36例结节性红斑患者进行治疗观察,现将结果报告如下:     

重症多形红斑患儿护理体会

重症多形红斑 ,即ＳｔｅｖｅｎｓＪｏｈｎｓｏｎ综合征。是一种以全身泛发性水肿红斑 ,伴有水疱、大疱及广泛而严重的粘膜损害为特征的急性皮肤病。全身症状严重 ,可伴发支气管肺炎、消化道出血、脑水肿和肝、肾损害而致死亡。常见于儿童 ,病程约 3～ 6周 ,死亡率5 %～ 15 % [1] 。我科在 1999年 12月～ 2 0 0 1年 3月共收治 5例 ,现将观察及护理体会报告如下。1　临床资料5例中男 2例 ,女 3例 ,年龄 1～ 3岁 ,住院时间 9天～ 15天。 5例患儿入院时均表现为全身泛发的多形性皮损 ,可见红斑、水疱、大疱 ,颈部、腋下、腹股沟等皮肤褶皱部位有…     

多形红斑型药疹40例临床分析

目的　分析多形红斑型药疹增多原因,探讨如何提高疗效及减少发生。方法　对 40例多形红斑型药疹致敏药物、临床表现、实验室检查及治疗进行分析。结果　①致敏药物多为青霉素类、解热镇痛类及中药类;②临床常见,重型较多;③以糖皮质激素为主综合治疗,疗效高。结论　多形红斑型药疹增多与多用、滥用及伪劣药品相关;糖皮质激素为主、全身治疗与局部治疗结合能显著提高疗效;规范用药,加强监管能减少其发生。     

甲基强的松龙治疗重症多形红斑17例疗效观察

1 临床资料 患者均为本科2000年1月～2006年7月收治病例，均符合Bastuji—Garin关于重症多形红斑的诊断依据。17例中男10例，女7例；年龄15～49岁，平均28．5岁，病程3～15天。发病前10例有发热、上呼吸道感染等症状；13例有明确用药史；3例发病前无明显诱因。病程中出现肝损害5例，其中3例表现为转氨酶升高，2例患者出现低蛋白血症，球蛋白升高；     

重型渗出性多形红斑110例临床分析

重型渗出性多形红斑是一种发病急的严重病症，皮肤粘膜广泛损害，同时有内脏改变，我院近１０年内收治１１０例，药物过敏所致者８４例（７６．３６％），体温在３９℃以上８５例（７７．２７％），皮损以水疱大为主６５例（５９．１０％），口腔和外阴粘膜同时损害９３年（８４．５５％），内脏有改变１０４例（９４．５５％）。     

重症多形红斑和Stevens-Johnson综合征

多形红斑（erythema multiforme,EM）患者具有同心圆形状的“靶形”皮损,但无黏膜损害和发热等系统症状。Stevens-Johnson综合征（Stevens-Johnson syndrome,SJS）患者不仅有皮肤的“靶形”损害,还有黏膜受累和系统症状,曾称为重症多形红斑（erythema multiforme majus,EMM）、重型多形渗出性红斑（erythema exsudativum multiforme majus）。一些学者认为EMM和SJS为同一种病,也有学者认为EMM和SJS不是一种病,SJS多由药物引起,可进展为中毒性表皮坏死松解症（TEN）,而EMM是EM的重型,不会进展为TEN,二者的病因、发病机制、临床表现和治疗均不同［1-3］……     

多形红斑型玫瑰糠疹

患者男,52岁.躯干、四肢红斑鳞屑1个月.皮肤科检查:躯干、四肢环形或靶形水肿性红斑,部分皮损中央见银白色鳞屑,其游离缘向皮损中心,呈领圈状.躯干部皮损长轴与皮纹一致,呈圣诞树样排列.掌、跖、皮肤黏膜未累及.病理示表皮局灶性角化过度及角化不全,棘细胞内及细胞间轻度水肿,真皮乳头水肿,真皮浅层及小血管周见淋巴、单核样细胞...     

多形红斑45例临床分析

目的加强临床医生对多形红斑(EM)的认识,提高其治愈率。方法回顾性分析45例多形红斑患者的临床症状及实验室检查资料。结果45例均有EM典型临床表现,男∶女发病比为1∶1.5,平均年龄35.74±22.03岁。轻症EM37(82.22%)例,重症EM8(17.78%)例。其中17例皮损组织病理示基底细胞液化变性空泡改变,真皮浅层淋巴细胞浸润为主。结论EM是一个病谱病,临床上具有特征性,去除病因,及时控制感染,重症EM早期应用足量、短程糖皮质激素可提高治愈率。     

Bullous erythema multiforme following herpes zoster and varicella-zoster virus infection

Four cases of herpes zoster-induced bullous erythema multiforme (EM) are reported. Three patients presented with widespread skin lesions 10 to 14 days after an episode of thoracic herpes zoster. In these patients a high increase in varicella-zoster virus (VZV) antibody titer was detected, indicating secondary VZV infection. Histologic examinations of skin biopsy from a patient with widespread lesions (case 4) revealed a mixture of EM, toxic epidermal necrolysis and herpetic virus infection. VZV should be included in the list of infectious agents able to trigger EM and Stevens-Johnson syndrome.     

Treatment of extensive erythema multiforme with topical gentian violet

Topical and systemic therapies for erythema multiforme have been widely described in the literature. The pathogenesis of erythema multiforme involves increased expression of vascular endothelial growth factor resulting in the promotion of microvascular permeability and angiogenesis. Gentian violet has been shown to have antiangiogenic properties. Here, we present a case of erythema multiforme successfully treated with topical gentian violet. We report the case of a patient who presented with erythema multiforme. Prior pertinent history included diabetes mellitus type I, limiting the clinical use of systemic corticosteroids. Topical gentian violet was used to treat the cutaneous lesions. Our patient responded well to treatment with topical gentian violet with stabilization and resolution of the lesions without using systemic therapy that may pose serious side effects in the setting of other comorbidities such as diabetes mellitus type I. This case highlights the variable therapeutic options available for treatment of erythema multiforme, including topical gentian violet. While further studies are needed, this case demonstrates the antiangiogenic properties and clinical utility of topical gentian violet in the treatment of erythema multiforme.     

Treatment of antiviral‐resistant recurrent erythema multiforme with dapsone

Recurrent erythema multiforme (REM) is a chronic disease characterized by frequent episodes of target cutaneous lesions in an acral distribution. Conventional treatment includes systemic corticosteroids and antiviral therapy. The aim of this study was to evaluate dapsone as a potential steroid sparing‐agent for the treatment of REM after a failed trial of at least one antiviral therapy (acyclovir, famciclovir, or valacyclovir). A retrospective chart review was conducted on thirteen patients with a diagnosis of REM who underwent treatment with dapsone after failing at least one antiviral therapy. Out of 13 patients, 6 showed complete response (CR) and 5 showed partial response (PR). The underlying cause was identified in 5 patients with all showing at least PR. Adverse effects, observed in 4 patients, included fatigue, macrocytic anemia, anxiety, insomnia and involuntary movements, and drug‐induced lupus erythematosus. A continuous course of dapsone, titrated up from 25 mg/day to a dose at which clinical improvement is seen with acceptable patient tolerance, is a viable steroid sparing‐agent for REM treatment after a failed trial of antiviral therapy.     

Erythema multiforme associated with contact dermatitis

A garment worker developed erythema multiforme concurrently with allergic contact dermatitis of the hands. Patch testing revealed sensitivity to nickel (which was present in her scissors) and to paraphenylenediamine (a commercial dye). During the course of the patch-test evaluation, both the hand dermatitis and the erythema multiforme became exacerbated. Later, patch testing to only nickel sulfate resulted in the development of erythema multiforme on the face and hands. The allergic pathogenesis, involving the absorption of an allergen through the skin and resulting in a type III allergic reaction from nickel, is discussed.     

Successful differentiation of herpes zoster‐associated erythema multiforme from generalized extension of herpes by rapid polymerase chain reaction analysis

The polymerase chain reaction (PCR) assay for varicella zoster virus (VZV), herpes simplex virus (HSV)‐1 and HSV‐2 is available for use. Sometimes the differential diagnosis of the generalized herpes zoster (HZ), HSV1/2, and drug eruption is difficult. We report a case of HZ followed by the vesicular erythema multiforme (EM)‐like lesion. In this case the use of PCR was of great assistance. A 78‐year‐old Japanese man without any significant previous history of disease was admitted to our hospital complaining of zosteriform vesicle on an erythematous base from his right shoulder to the upper arm. We diagnosed him with HZ at the level of right Th2. In spite of the prompt start of antiviral therapy, a secondary new vesiculous erythema developed on his trunk. Clinically, it was quite difficult to differentiate the lesion from the generalized HZ. Rapid PCR assay of effusion and crust for VZV was performed. A PCR assay of VZV was positive for the crust taken from the primary lesion, while it was negative for the effusion and crust of the secondary widespread lesion. We diagnosed the secondary widespread lesion as an EM‐type drug eruption induced by acyclovir, or an EM associated with herpes zoster. We then stopped the use of acyclovir and applied steroid ointment of a very strong class for the secondary lesions, which improved after a few days. A PCR assay for VZV was useful for ruling out the generalized HZ in our case with secondary developed vesiculous lesions.     

Mephenesin contact dermatitis with erythema multiforme features

5 patients, all using a mephenesin -containing ointment, with an acute contact dermatitis also presented an id-like spread with erythema multiforme features. In 4 patients, patch tests were performed and since mephenesin was the common allergen in each of these cases, we may assume that this is also the cause of the erythema multiforme-like lesions.