PDF(Pubmed)
Abstract：
Toxic epidermal necrolysis (TEN) is a rare but serious immune-mediated life-threatening skin and mucous membrane reaction that is mainly caused by drugs, infections, vaccines, and malignant tumors. A 74-year-old woman presented with a moderate fever of unknown cause, which was relieved after 2 days, but with weakness and decreased appetite. Red maculopapules appeared successively on the neck, trunk, and limbs, expanding gradually, forming herpes and fusion, containing a yellow turbidous liquid and rupturing to reveal a bright red erosive surface spreading around the eyes and mouth. The affected body surface area was >90%. The severity of illness score for toxic epidermal necrolysis was 2 points. The drug eruption area and severity index score was 77. She was diagnosed with TEN caused by hepatitis A virus and treated with 160 mg/day methylprednisolone, 300 mg/day cyclosporine, and 20 g/day gammaglobulin. Her skin showed improvements after 3 days of treatment and returned to nearly normal after 1 month, and liver function was completely normal after 2 months.
摘要：
中毒性表皮坏死松解症（TEN）是一种罕见但严重的免疫介导的危及生命的皮肤和粘膜反应，主要由药物引起，感染,疫苗,和恶性肿瘤。一名74岁的妇女出现不明原因的中度发烧，两天后缓解了，但是虚弱和食欲下降。颈部先后出现红色斑丘疹，树干,和四肢，逐渐扩大,形成疱疹和融合，含有黄色浑浊的液体，并破裂，露出明亮的红色侵蚀表面，散布在眼睛和嘴巴周围。受影响的身体表面积>90%。中毒性表皮坏死松解症的病情严重程度评分为2分。药疹面积和严重度指数评分为77。她被诊断为甲型肝炎病毒引起的TEN，并接受了160毫克/天的甲基强的松龙治疗，300毫克/天环孢菌素，和20克/天丙种球蛋白。治疗3天后，她的皮肤改善，1个月后恢复到接近正常，2个月后肝功能完全正常。
