Severe cutaneous adverse drug reactions.
Severe cutaneous adverse drug reactions.
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DOI：
10.1016/j.mjafi.2013.01.007
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发表时间：
2013-10-01
期刊：
影响因子：
--
通讯作者：
Pragasam, Vijendran
中科院分区：
文献类型：
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作者：
Verma, Rajesh;Vasudevan, Biju;Pragasam, Vijendran
严重的皮肤药物反应是任何医院急诊室最常见的医学挑战之一。其表现从黄斑丘疹到严重的全身症状，如肾功能衰竭和心血管疾病。中毒性表皮坏死松解、红皮病、伴嗜酸性粒细胞增多及全身性症状的药物皮疹、急性全身性脓疱病和药物性血管炎是常见的皮肤药物反应，可导致严重的发病率甚至死亡率。仔细记录药物摄入后的滞后期和相关症状，并详细检查皮肤、黏膜和各系统，有助于这些反应的早期诊断。早期停止使用致病药物，根据具体情况进行特异性治疗，包括皮质类固醇、环孢素和静脉注射免疫球蛋白，以及支持性治疗和局部措施，有助于挽救大多数患者。本文综述了这些重要的皮肤药物反应及其处理方法。
Severe cutaneous drug reactions are one of the commonest medical challenges presenting to an emergency room in any hospital. The manifestations range from maculopapular rash to severe systemic symptoms like renal failure and cardiovascular compromise. Toxic epidermal necrolysis, erythroderma, drug rash with eosinophilia and systemic symptoms, acute generalised exanthematous pustulosis and drug induced vasculitis are the common cutaneous drug reactions which can have severe morbidity and even mortality. Careful history taking of the lag period after drug intake and associated symptoms, along with detailed examination of the skin, mucosa and various systems, help in early diagnosis of these reactions. Early stoppage of the incriminating drug, specific therapy including corticosteroids, cyclosporine and intravenous immunoglobulin depending on the case along with supportive therapy and local measures help in salvaging most patients. An overview of these important cutaneous drug reactions along with their management is being reviewed in this article.