25例急性泛发性发疹性脓疱病的临床分析

目的：探讨急性泛发性发疹性脓疱病（acute generalized exanthematous pustulosis，AGEP）的病因、临床特征及处理对策，为临床医师安全用药和药师药学服务提供参考。方法：采用Euro SCAR （the european study of severe cutaneous adverse reactions） 评分表和药物不良反应因果评价法对2011年7月-2018年7月某三级皮肤病医院收治的25例AGEP病例进行分析。结果：25例患者均由药物引起，可疑致敏药物以抗菌药物为主（16例，64%），其次为非甾体类抗炎药（3例，12%），中药及中成药（2例，8%），苯二氮类镇静催眠药地西泮（1例，4%），抗疟药羟氯喹（1例，4%），多巴胺第2受体拮抗剂甲氧氯普胺（1例，4%）及选择性5-羟色胺₄受体激动药莫沙必利（1例，4%）。25例患者经治疗均好转出院。结论：药物，尤其是抗菌药物是诱发AGEP的主要原因，临床使用中应加强药学监护，发现异常应及时停药并给予对症处理，控制并发症的发生。

Clinicalanalysis of 25 cases of acute generalizedexanthematous pustulosis

OBJECTIVE To investigate the etiology, clinical features and treatment strategies of acute generalized exanthematous pustulosis (AGEP), and to provide reference for clinicians' safe medication and pharmacists' service. METHODS Twenty-five cases of AGEP admitted to a tertiary dermatology hospital from July 2011 to July 2018 were analyzed using the Euro SCAR (The European Study of Severe Adverse Reactions) scale and the causality assessment of adverse drug reactions. RESULTS All of the 25 patients were induced by drugs. The most suspected sensitizing drugs were antibiotics (16 cases, 64%), followed by non-steroidal anti-inflammatory drugs (3 cases, 12%), traditional Chinese medicine and Chinese patent medicine (2 cases, 8%), benzodiazepine sedative hypnotic diazepam (1 case, 4%), antimalarial hydroxychloroquine (1 case, 4%), dopamine 2 receptor antagonist metoclopramide (1 case, 4%) and selective serotonin₄ receptor agonist mosapride (1 case, 4%). All 25 patients were treated and discharged after treatment. CONCLUSION Drugs, especially antibiotics, are the main cause of AGEP, and pharmaceutical care should be strengthened in clinical use. If abnormalities are found, drug withdrawal and symptomatic treatment should be given in time to control the occurrence of complications.