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病例摘要男、6岁半、高烧伴全身皮疹3天于1980年11月,4日入院.病初头颈部即现散在点状红丘疹.次日注射凡拉蒙后,皮疹增多,并羞明、声嘶、口痛,一咳血性痰,:黑便,尿茶红负,高热不退,全身症状重.  相似文献   

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We report the case of a 26-year-old student with erosive skin changes on his oral and genital mucosa and skin as well as on his thighs twice after cocaine snorting. The second of these two episodes was documented histologically, and other underlying causes of disease were excluded. A diagnosis of recurring Stevens-Johnson syndrome was made. Treatment was initiated with bed rest, systemic prednisone at 1 mg/kg body weight and liquid nutrition. Mucosal changes resolved within 4 days. On follow-up the patient remained free of symptoms while abstaining from the particular cocaine street mix in question. Cocaine has been involved in seizures, headaches, ischemic strokes, intracerebral hemorrhage, cerebral vasculitis, Churg-Strauss vasculitis, palpable purpura and Henoch-Sch?nlein vasculitis. Bullous skin disease in association with cocaine has been reported in 1 patient. To our knowledge, we report the first case of Stevens-Johnson syndrome associated with cocaine snorting.  相似文献   

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Stevens-Johnson syndrome is an acute, inflammatory eruption of the skin and mucous membranes often associated with drug ingestion. A forty-five-year-old woman showed symptoms consistent with Stevens-Johnson syndrome two days after indapamide therapy was begun for the treatment of hypertension. Initial manifestations consisted of headaches, sore throat, cough, and symptoms of conjunctival injection, including redness and swelling. Approximately two weeks later, the patient noted skin eruptions involving the conjunctiva, lips, face, neck, trunk, and extremities. She was treated with cool compresses, antiseptics, ophthalmic antibiotics and steroids, and oral prednisone. Symptoms began to resolve approximately eight days after indapamide was discontinued and treatment was begun. Although rare, Stevens-Johnson syndrome should be considered in the differential diagnosis of a patient with a history of indapamide ingestion who presents with malaise, fever, and skin eruptions.  相似文献   

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Stevens-Johnson syndrome from metronidazole   总被引:1,自引:0,他引:1  
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BACKGROUND: Lamotrigine is a new anticonvulsant belonging to the triazine family. Several cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been described in patients taking this drug. We report 2 cases in children attending the same hospital. CASE REPORTS: Two children, aged 9 and 13 years, developed SJS and TEN respectively, 3 and 28 days after lamotrigine was added to their usual anticonvulsant regimen. In both cases, outcome was favorable despite major decline in psychomotor capacity in one. In the first case, chronological attributability was plausible for lamotrigine and doubtful for sodium valproate, clonazepam and hydrocortisone. In the second case, chronological attributability was probable for amoxicillin, plausible for lamotrigine and doubtful for sodium valproate, but the numerous previous absorptions of amoxicillin made lamotrigine more suspect. DISCUSSION: The risk of Steven-Johnson syndrome and toxic epidermal necrolysis is high with lamotrigine with an estimated frequency of 1/1000. This risk is probably higher than with other anticonvulsants. Associating lamotrigine with sodium valproate increases the frequency of adverse skin reactions.  相似文献   

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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]……  相似文献   

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IntroductionThe aim of this work is to reflect the clinical experience of the Dermatology Department of Hospital General in Valencia with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) or Lyell's syndrome over the last 15 years.MethodsData on epidemiology, likely causal agents, complementary tests, concomitant pathologies, management, evolution and complications was gathered through a retrospective study.ResultsThirteen patients were included, with a mean age of 53 years. The most frequently involved drugs were antibiotics (50 %), followed by anti-convulsants (16.6 %). The mucous membranes were involved in 84.6 % of the cases. 61.5 % of the patients presented with systemic symptoms. The most frequent laboratory finding was hypoproteinemia. Corticosteroids were used in 69 % of the cases, and intravenous immunoglobulins in 15 %. Two oncological patients with a diagnosis of TEN died (15 % overall mortality).ConclusionsSJS and TEN are infrequent mucocutaneous reactions, often drug induced, with significant associated morbidity and mortality. Their pathogenesis is still partially unknown, and no specific treatment has been proven to be clearly beneficial; therefore, the best treatment consists of early diagnosis, the withdrawal of the suspect drug and support therapy.  相似文献   

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Acetazolamide is a sulfonamide derivative and carbonic anhydrase inhibitor used to lower intraocular pressure in glaucomatous patients. Stevens-Johnson syndrome (SJS) toxic epidermal necrolysis (TEN) associated with acetazolamide treatment has been diagnosed in Japanese, Japanese-American and Indian patients. Herein, we report the second Korean case of SJS-TEN associated with acetazolamide treatment. The result of human leukocyte antigen (HLA) typing of our patient was positive for HLA-B59. According to recent research, HLA-B59 has been detected in SJS caused by metazolamide, which is analogous to acetazolamide. This suggests a possible relationship between genetic background and SJS-TEN-associated acetazolamide treatment. Theretofore, acetazolamide should be prescribed to Korean patients with the same discreet caution.  相似文献   

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Stevens-Johnson syndrome (SJS) is an acute mucocutaneous eruption nosologically related to erythema multiforme (EM) and toxic epidermal necrolysis (TEN). Medications are the most common triggering factors for SJS, with anticonvulsants, sulfonamides, penicillins, allopurinol, and nonsteroidal anti-inflammatory drugs (NSAIDs) most commonly implicated. SJS is very rarely associated with tetracyclines. We report a case of doxycycline-induced SJS in a 46-year-old man.  相似文献   

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