PDF(Pubmed)
Abstract：
Epidermal necrolysis is a severe dermatological condition usually associated with adverse drug reactions involving the mucosa. Stevens-Johnson syndrome (SJS) is clinically diagnosed when an epidermal detachment of less than 10% of body surface area (BSA) is involved. In contrast, toxic epidermal necrolysis (TEN) is characterized when there is an epidermal detachment of more than 30% BSA. Epidermal necrolysis can be described as ulcerated, painful, and erythematous lesions typically appearing on the skin. Typical clinical presentations of SJS include epidermal detachment of less than 10% of BSA and mucosal involvement with prodromal flu-like symptoms. Atypical presentations of focal epidermal necrolysis include the presence of lesions in a dermatomal pattern, associated itching, and idiopathic cause. We report a rare case of suspected herpes-zoster virus (HZV)-like SJS with negative HZV serum PCR and negative varicella-zoster virus (VZV) biopsy immunostaining. This rare case of SJS was resolved with the administration of IV acyclovir and Benadryl.
摘要：
表皮坏死松解是一种严重的皮肤病，通常与涉及粘膜的药物不良反应有关。当涉及小于体表面积（BSA）的10％的表皮脱离时，临床诊断为Stevens-Johnson综合征（SJS）。相比之下,毒性表皮坏死松解症（TEN）的特征是当存在超过30％BSA的表皮脱离时。表皮坏死松解症可以描述为溃疡，痛苦,和红斑病变通常出现在皮肤上。SJS的典型临床表现包括少于10%的BSA的表皮脱离和伴有前驱流感样症状的粘膜受累。局灶性表皮坏死松解症的非典型表现包括皮瘤模式的病变的存在，相关的瘙痒，和特发性原因。我们报告了一例罕见的疑似带状疱疹病毒（HZV）样SJS，HZV血清PCR阴性，水痘带状疱疹病毒（VZV）活检免疫染色阴性。这种罕见的SJS病例通过IV阿昔洛韦和Benadryl的给药得以解决。
