卡马西平致全身大疱性表皮松解

1例66岁男性患者因三叉神经痛服用卡马西平100 mg,2次/d。服药第10天出现全身皮疹伴瘙痒、触痛。5 d后其症状发展为眼睑、鼻腔、口唇和口腔黏膜破溃、糜烂以及躯干、四肢弥漫性斑丘疹和尼氏征阳性。诊断为药物所致大疱性表皮松解。停用卡马西平,给予甲泼尼龙、人免疫球蛋白、人血白蛋白、阿奇霉素及环磷酰胺等治疗,10 d后皮疹基本消退。

Carbamazepine-induced bullosa epidermolysis

A 66-year-old man received carbamazepine 100 mg twice daily for trigeminal neuralgia.On day 10 of therapy,he developed generalized skin rash with pruritus and tenderness.Five days later,his symptoms progressed to ulceration and erosion involving his eyelids,nasal cavity,lips and oral mucosa,along with diffuse maculopapular rash was on his trunk and limbs,and a positive Nikolsky＇s sign.Drug-induced bullosa epidermolysis was diagnosed.Carbamazepine was discontinued.He was treated with methylprednisolone,human immunoglobulin,human serum albumin,azithromycin and cyclophosphamide.Ten days later,his rash basically subsided.