PDF(Pubmed)
Abstract：
Stevens-Johnson Syndrome (SJS), a severe mucocutaneous hypersensitivity reaction primarily triggered by drugs, poses a low-incidence, high-mortality challenge. This report explores its clinical nuances and emphasizes supportive care as the mainstay of treatment. A 74-year-old female, burdened with a complex medical history, presented with a non-pruritic macular rash escalating to skin and oral mucosal involvement. A recent introduction of dipyrone (metamizole) implicated drug-induced SJS. Histopathological confirmation guided treatment involving supportive care, corticosteroids, and wound care, resulting in clinical improvement. The case underscores the significance of histopathological confirmation and thorough medication history in navigating SJS complexities, especially in patients with comorbidities like connective tissue disease. A successful multidisciplinary approach and the decision for post-discharge monitoring highlight the intricate management challenges. This case illuminates the intricate interplay of medication-induced hypersensitivity, comorbidities, and management challenges in SJS. Optimal outcomes require prompt diagnosis, trigger identification, and a multidisciplinary treatment approach, emphasizing ongoing research and clinical vigilance.
摘要：
史蒂文斯-约翰逊综合征（SJS），主要由药物引发的严重的皮肤粘膜过敏反应，构成低发病率，高死亡率挑战。本报告探讨了其临床细微差别，并强调支持性护理是治疗的主要手段。一位74岁的女性,背负着复杂的病史，表现为非瘙痒性黄斑皮疹，逐渐升级为皮肤和口腔粘膜受累。最近引入的二吡喃酮（美甲咪唑）涉及药物诱导的SJS。组织病理学确认指导治疗，包括支持治疗，皮质类固醇,和伤口护理，导致临床改善。该病例强调了组织病理学确认和彻底的用药史在导航SJS复杂性方面的重要性，尤其是有结缔组织病等合并症的患者。成功的多学科方法和出院后监测的决定突出了复杂的管理挑战。这个案例阐明了药物引起的超敏反应的复杂相互作用，合并症,和SJS中的管理挑战。最佳结果需要及时诊断，触发器识别,和多学科治疗方法，强调正在进行的研究和临床警惕。
