卡托普利致多形红斑

患者男,72岁。因全身红斑伴瘙痒3d,于2002年9月16日入院。3d前因劳动后感头昏、乏力,自认为血压高,故服卡托普利25mg。服药后约30min,双上肢开始出现散在红色皮疹、瘙痒。继而遍及全身,逐渐融合成片,呈斑片状。既往未服过该药,入院查体:T36.6℃,P74次/min,R20次/min,BP125/65mmHg(1mmHg=0.133kPa)。神清,呼吸平稳,全身皮肤(包括颜面)可见红色斑片状,高出皮面,压之退色的皮疹可见抓痕及部分剥脱,疹间见少许正常皮肤。浅表淋巴结无肿大,咽无充血。颈静脉无怒张,胸廓无畸形,双肺呼吸音清晰。心界不大,心率74次/min,律齐,各瓣膜听诊区未闻及…     

Lamotrigine-induced erythema multiforme mimicking contact dermatitis

Erythema multiforme is an acute, hypersensitivity reaction of the skin often secondary to medications. Lamotrigine is a relatively new anticonvulsant medication approved for seizure and psychiatric disorders. Although the overall incidence of cutaneous reactions to lamotrigine is high, the incidence of serious eruptions such as erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis is low. Vigilant surveillance for any cutaneous eruption in patients on lamotrigine is important, particularly in the first 8 weeks, as prompt discontinuation of the medication can prevent progression. We report a case of erythema multiforme secondary to lamotrigine, which clinically resembled a contact dermatitis, and review the management of lamotrigine associated cutaneous eruptions.     

A case of ciprofloxacin-induced erythema multiforme

A 25 year old male admitted to the medical college hospital with presenting complaint of fever, skin rashes and itching. Before admission he had consulted a local doctor for fever, who had prescribed him Tablet ciprofloxacin 500mg twice daily and Tablet. Paracetamol 500 mg thrice daily. The patient had taken 6 tablets of ciprofloxacin before he developed the above symptoms. On detailed clinical examination multiple erythematous papule and plaques were present on the face, abdomen and neck. Target (Iris) lesions were seen on the extersor surface of both upper and lower limbs measuring about 1-2 cm in size. Multiple erythematous lesion were also found in mucosa of soft and hard palate, Uvula and posterior pharyngeal wall. Lower lips were swollen and edematous, Lymphnodes in the neck were enlarged and tender. The clinical features with which the patient presented were similar to those seen in a typical case of erythema multiforme and the patient recovered after stopping ciprofloxacin, Further rechallenge with oral ciprofloxacin was not done in the interest of patient and due to ethical constraints. This case is being reported for rare and potential fatal drug reaction with ciprofloxacin.     

吡罗昔康致重症多型红斑型药疹

患者男,70岁。因左下肢膝、踝关节疼痛,于2003年12月8日在当地医院就诊。给予吡罗昔康20mg,1次/d口服。服药10d后,患者头面、四肢、躯干部皮肤出现红斑、丘疹,并形成水疱,水疱易破,自觉疼痛,体温升高至38℃。未就诊,未予任何治疗措施,继续服用吡罗昔康。12月25日,患者因皮疹加重并累及黏膜来院就诊。既往体健,无药物过敏史,体格检查:T36.2℃,HR76次/min,R17次/min,BP120/80mmHg。患者全身皮疹密集,水疱、大疱破溃后有清液渗出并露出鲜红色的糜烂面,呈对称分布,以头面部、四肢末端为重。舌面、口腔颊黏膜可见红斑糜烂、上下唇黏膜、双眼黏…     

交沙霉素致多形性红斑药疹2例

例1女,35岁,因咽喉疼痛1周,于2002年7月15日来我院就诊。患者既往无药物食物过敏史。查体:T36.5℃,全身皮肤、粘膜未见黄染、出血点及皮疹,咽部明显充血,未见糜烂,双侧扁桃体无肿大,心、肺正常。诊断为“咽炎”,给予交沙霉素0.4g,po,tid 。5h后患者复诊,诉服药2h后全身出现皮疹,伴瘙痒。查体:T36.8℃,P75次·min-1,BP120/75mmHg(1mmHg=0.133kPa),咽部充血明显,心、肺未见异常,全腹平软,无压痛反跳痛,肝脾肋下未触及。皮肤症状:颈部、躯干、四肢皮肤散在分布钱币大小的水肿性圆形红斑,丘疹,边缘清晰,中心呈紫红色,未见水疱、糜烂及渗出,…     

Celecoxib-induced erythema multiforme with glyburide cross-reactivity

Erythema multiforme is an acute inflammatory skin reaction that often is caused by drugs, especially sulfonamides and their derivatives. Celecoxib, a cyclooxygenase-2 inhibitor, is a sulfonamide derivative commonly prescribed to treat arthritis in patients who cannot tolerate or who have a contraindication for taking traditional nonsteroidal antiinflammatory agents. A 57-year-old man with a previously undocumented sulfa allergy experienced an allergic skin reaction and had difficulty breathing secondary to throat swelling. His condition was believed to be erythema multiforme associated with the introduction of celecoxib into his drug regimen. His drug therapy was discontinued, but a subsequent reaction occurred when the sulfonamide derivative glyburide was reintroduced. It is important for clinicians to obtain a careful history and perform a thorough medical evaluation in all patients receiving sulfonamides and their derivatives, as a potentially life-threatening allergic reaction may be prevented.     

Persistent erythema multiforme and CMV infection

Persistent erythema multiforme is a rare disorder with only 23 known cases reported in the literature. Persistent erythema multiforme has been reported in association with Epstein-Barr virus, herpes virus, hepatitis C virus, influenza, inflammatory bowel disease, and a variety of neoplasms. To our knowledge, this case is the first case of persistent erythema multiforme reported in association with cytomegalovirus infection.     

塞来昔布引起急性渗出性多形性红斑

1名56岁男性患者，因风湿性关节炎口服塞来昔布200mg。约2h后双上肢出现散在的多形性红斑，随即红斑遍布全身，伴灼热、瘙痒、渗出，患者表现为发热（T38℃）、胸痛、排尿困难，眼睑和上唇水肿，口腔黏膜和尿道口充血。实验室检查：WBC 10.5×10^9／L，N0，709，L0．201。给予抗过敏和对症治疗3d后，症状缓解，1周后红斑完全消退，但皮肤留下明显色素沉着。     

碘克沙醇注射液致重症多形红斑型药疹

1例82岁男性冠状动脉粥样硬化性心脏病患者,注射碘克沙醇注射液约60ml行动脉造影术。术后第2天患者全身皮肤出现红色斑疹伴瘙痒,停用阿司匹林、比索洛尔、阿托伐他汀、氯吡格雷等所有药物,给予抗过敏治疗8d,症状逐渐加重,考虑为碘克沙醇引起的迟发型过敏反应。实验室检查示：白细胞计数10．1×10^9／L,中性粒细胞0．79,嗜酸粒细胞0．02,超敏C反应蛋白13．9μg／L,降钙素原0．189μg／L。诊断为重症多形红斑型药疹。给予甲泼尼龙琥珀酸钠、夫西地酸钠、利多卡因＋地塞米松加人碳酸氢钠溶液护理口腔、生理盐水＋庆大霉素＋地塞米松湿敷唇部等治疗后症状缓解。     

炔雌醇环丙孕酮致重症多形红斑型药疹

1例43岁女性患者因功能失调性子宫出血予炔雌醇环丙孕酮口服治疗,每次1片（每片含醋酸环丙孕酮2 mg和炔雌醇0.035 mg）,1次/d。患者规律服药,第9天全身出现散在虹膜样红斑伴瘙痒,当日停服该药。次日,患者全身虹膜样红斑增多、增大,瘙痒难忍,疼痛剧烈,颜面部皮疹融合成片状,面部肿胀明显,诊断为多形红斑型药疹。给予咪唑斯汀、氯雷他定及甘草酸二铵口服,复方倍他米松单次肌内注射。第3天起加用地塞米松5 mg入5%葡萄糖注射液500 ml和甘草酸二铵氯化钠注射液150 mg（250 ml）静脉滴注,1次/d;曲安奈德益康唑乳膏外用。8 d后患者症状减轻,红斑渐消退。     

依替米星致多形性红斑1例

1 病例资料患者,男,60岁,体质量70 kg.于2019年6月2日12:00因腹痛腹泻入天津市第五中心医院肠道门诊,诊断为腹痛待查,急性胃肠炎.患者既往体健,否认食物过敏史,有口服左氧氟沙星过敏史,表现仅为轻微皮肤瘙痒,可耐受且未处理,后自行缓解.父亲青霉素过敏(程度不详).患者入院查体:体温37.5℃,心率每分钟...     

Dapsone in the treatment of persistent erythema multiforme

Erythema multiforme (EM) is usually an acute and self-limited inflammatory reaction of the skin and mucous membranes. Attacks may be sporadic or recurrent, and generally last for 1 to 3 weeks. Rarely, an episode of EM may fail to abate. This continuous and uninterrupted occurrence of typical and atypical lesions is known as persistent EM. We present a case responsive to dapsone.     

Drug-induced erythema multiforme: a possible immunologic pathogenesis

A 37-year-old female developed erythema multiforme 17 days after beginning carbamazepine for complex partial seizures. The carbamazepine was discontinued and phenytoin begun. A new rash developed and phenytoin therapy was stopped. In vitro immunologic studies were conducted in an effort to understand the pathogenesis of the rashes. Enhancement of stimulated in vitro lymphocyte proliferation from the patient occurred in the presence of carbamazepine and phenytoin. Neither drug had an enhancing effect on lymphocyte proliferation from a control subject. These data, together with clinical data, strongly suggest an immunologic pathogenesis for drug-induced erythema multiforme.     

异甘草酸镁致多形性红斑1例

病例     

Multifocal, fixed-drug eruption masquerading as recurrent erythema multiforme

Fixed drug eruptions often have a characteristic appearance, which, when correlated with the clinical history, can be easily identified. However, multifocal fixed drug eruptions, especially the non-pigmenting variety, can present a diagnostic challenge, especially in the absence of a complete medication history. We present such a case, in which the patient was taking two over-the-counter medications, both of which contain uncommon causes of multifocal fixed drug eruptions.     

丙戊酸钠缓释片致重症多形红斑

患儿女,6岁,体重20kg。于2005年10月22日来我院神经科门诊就诊,诊断为“癫痫”,回乡后开始服用丙戊酸钠缓释片(德巴金),每次400m g1次/d。患儿于11月2日出现发热,T38.6℃,无咳嗽及流涕等其他症状,自行服用阿司匹林苯巴比妥片(阿苯片)退热。次日患儿再次出现发热,面部出现暗红色斑点,家长自行给予对乙酰氨基酚片(扑热息痛)退热。第3天在当地医院诊断为“咽炎”,静脉滴注头孢拉啶,并予布洛芬混悬液(恬倩)退热,(以上用量均不详)。治疗无效体温仍为38℃～39℃,皮疹逐渐增多,再次来我院,以重症多形红斑收入院。入院时患儿双面颊、耳廓可见大量直…     

依诺肝素钠致多形性红斑1例

【病例】患者,女,68岁,因"右乳癌术后复发、转移"入院。入院时查体:体温 36.5℃,神清,精神可,右乳术后改变,右上肢软组织肿胀明显,肢体活动受限,心脏听诊无殊,腹平软,无压痛反跳痛,移动性浊音(-),肝脾肋下未及肿大,双肾区叩痛(-),双下肢不肿,神经系统(-)。