摘要
儿童重症药疹是一类罕见的,可能危及生命的严重皮肤药物不良反应,包括Stevens-Johnson综合征(SJS)、中毒性表皮坏死松解症(TEN)、伴嗜酸性粒细胞增多和系统症状药疹(DRESS)、急性泛发性发疹性脓疱病(AGEP)、泛发性大疱性固定性药疹(GBFDE)和药物引起的速发型严重过敏反应。虽然各型重症药疹的表现不一,但往往起病突然,进展迅速,死亡率高,早期识别和适当的管理对生存至关重要。药疹的诊断具有挑战性,临床上缺少能明确致病药物的方法和手段。治疗上应立即停用潜在致病药物和加强支持治疗,全身使用糖皮质激素和静脉注射免疫球蛋白是治疗重症药疹最常用的方法;肿瘤坏死因子抑制剂治疗儿童重症药疹仍在探索中。本文重点关注了儿童重症药疹的临床特点、诊断方法和治疗策略,以指导临床治疗。
Severe drug eruption in children may cause severe cutaneous adverse drug reactions(SCARs),which are considered to be fatal and life-threatening,including Stevens-Johnson syndrome(SJS),toxic epidermal necrolysis(TEN),drug reactions with eosinophilia and systemic symptoms(DRESS),acute generalized exanthemous pustulosis(AGEP),generalized bullae fixed drug eruption(GBFDE),and drug anaphylaxis.Although the manifestations of various types of severe drug eruption are different,they often have sudden onset,rapid progression,and high mortality.Early recognition and appropriate management are crucial for survival.The diagnosis of drug eruption is challenging and there is a lack of methods to identify pathogenic drugs in clinical.In the treatment of drug eruption,immediate withdrawal of potentially causative drugs and specific supportive treatment is of great importance.Intravenous immunoglobulins and systemic corticosteroids are the most frequently used treatments for SCARs.New biologic agents such as tumor necrosis factor inhibitors for severe drug eruption in children still being explored.This article focuses on the clinical characteristics,diagnostic methods and treatment strategies of severe drug eruption in children to guide clinical management.
作者
汤建萍
TANG Jianping(Hunan Children’s Hospital,Hunan 410007,China)
出处
《皮肤科学通报》
2022年第2期102-109,M0003,共9页
Dermatology Bulletin
