Erythema Multiforme

多形红斑
  • 文章类型: Case Reports
    Rowell综合征是一种以红斑狼疮为特征的自身免疫性疾病,多形性红斑皮肤病变,和斑点抗核抗体。我们报告了一例妇女,该妇女表现为多形性红斑,具有目标型皮肤病变和外阴植被,符合Rowell综合征和尖锐湿疣的标准。两种情况同时发生的文献很少报道。
    Rowell\'s syndrome is an autoimmune disease characterized by lupus erythematosus, erythema multiforme skin lesions, and speckled antinuclear antibody. We report the case of a woman who presented with erythema multiforme with target-type skin lesions and vulvar vegetation who fulfilled the criteria for Rowell\'s syndrome and condyloma acuminatum. The simultaneous occurrence of both conditions has rarely been reported in the literature.
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  • 文章类型: Journal Article
    目的:这篇综述旨在总结光学相干断层扫描(OCT)在口腔黏膜疾病中的最新应用,促进对此类疾病的准确和早期诊断,很难区分。
    关于OCT在口腔黏膜疾病中应用的参考文献主要来自PubMed,Embase,WebofScience和Scopus数据库,使用关键词:“光学相干断层扫描”和“口腔粘膜/口腔癌/口腔潜在恶性疾病/口腔扁平苔藓/口腔白斑/口腔红斑/盘状红斑狼疮/口腔自身免疫性大疱性疾病/口腔溃疡/多形性红斑/口腔黏膜炎”。
    结果:发现OCT在早期检测中显示出很有希望的应用潜力,诊断,鉴别诊断,监测口腔癌和口腔发育不良病变,以及肿瘤边缘的勾画。OCT在口腔潜在恶性疾病的诊断中也发挥着越来越重要的作用。口腔粘膜大疱性疾病,口腔溃疡性疾病,多形性红斑,以及口腔黏膜炎的早期发现。
    结论:光学相干断层扫描,作为一种以实时为特征的新型光学技术,非侵入性,动态和高分辨率成像,作为诊断的辅助工具非常有用,鉴别诊断,口腔黏膜疾病的监测和治疗评价。
    OBJECTIVE: This review aims to summarize the latest application of optical coherence tomography (OCT) in oral mucosal diseases, promoting an accurate and earlier diagnosis of such disorders, which are difficult to be differentiated.
    UNASSIGNED: References on the application of OCT in oral mucosal diseases were mainly obtained from PubMed, Embase, Web of Science and Scopus databases, using the keywords: \"optical coherence tomography and \'oral mucosa/oral cancers/oral potentially malignant diseases/oral lichen planus/oral leukoplakia/oral erythroplakia/discoid lupus erythematosus/oral autoimmune bullous diseases/oral ulcers/erythema multiforme/oral mucositis\'\".
    RESULTS: It is found that OCT is showing a promising application potential in the early detection, diagnosis, differential diagnosis, monitoring of oral cancer and oral dysplastic lesions, as well as the delineation of tumor margins. OCT is also playing an increasingly important role in the diagnosis of oral potentially malignant disorders, oral mucosal bullous diseases, oral ulcerative diseases, erythema multiforme, and the early detection of oral mucositis.
    CONCLUSIONS: Optical coherence tomography, as a novel optical technique featured by real-time, noninvasive, dynamic and high-resolution imaging, is of great use to serve as an adjunct tool for the diagnosis, differential diagnosis, monitoring and therapy evaluation of oral mucosal diseases.
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  • 文章类型: Letter
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  • 文章类型: Review
    背景:据报道,皮肤毒性是程序性细胞死亡抑制剂最常见的免疫相关副作用。以前与Sintilimab有关的报告包括皮疹,瘙痒,白癜风,史蒂文斯-约翰逊综合征,中毒性表皮坏死松解症,等等。
    方法:一名66岁的男性患者接受Sindilimab作为乙状结肠癌的单药治疗。在第二次处方之后,他出现了更严重和广泛的皮疹。
    方法:考虑Sindilimab引起的多形红斑药疹的诊断。
    方法:患者接受静脉注射和口服甲基强的松龙,常规抗组胺药和外用糖皮质激素。
    结果:患者住院期间症状逐渐缓解,症状缓解后出院。他拒绝继续使用Sintilimab。
    结论:这是首例报道的Sindilimab引起的多形性红斑药疹。建议告知患者使用免疫检查点抑制剂后可能发生的潜在皮肤病毒性,这样我们就可以防止它的进一步发展,并避免免疫检查点抑制剂的停药。
    BACKGROUND: Dermatologic toxicity has been reported as the most common immune-related side effect of programmed cell death 1 inhibitors. Previous reports related to Sintilimab include rash, pruritus, vitiligo, Stevens-Johnson syndrome, toxic epidermal necrolysis, and so on.
    METHODS: A 66-year-old man was treated with Sintilimab as monotherapy for sigmoid colon cancer. After the second prescription, he developed a more severe and widespread rash.
    METHODS: The diagnose of erythema multiforme drug eruption induced by Sintilimab was considered.
    METHODS: The patient received intravenous and oral methylprednisolone, routine antihistamines and topical gluccorticoids.
    RESULTS: The patient\'s symptoms were gradually relieved during hospitalization and was discharged following resolution of symptoms. He refused to continue using Sintilimab.
    CONCLUSIONS: This is the first reported case of Sintilimab-induced erythema multiforme drug eruption. It is advisable to inform patients of potential dermatologic toxicity that may occur after using immune checkpoint inhibitors, so that we may prevent the further development of it and avoid the discontinuation of immune checkpoint inhibitors.
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  • 文章类型: Case Reports
    背景:关于利伐沙班用于儿科患者治疗的数据有限。本报告介绍了一例可能的利伐沙班诱发的儿童多形性红斑。病例总结:一名5.5岁的抗磷脂综合征(APS)女性患者口服利伐沙班片剂2.5mg,每天两次,持续16天。随后,患者双脚和臀部出现轻微瘙痒感,无明显原因。第二天,多形性红斑以分散的方式出现在整个身体中。红斑呈现高于皮肤表面并部分合并到皮肤区域。随着红斑的范围和程度的增加,停止所有口服药物治疗.地塞米松磷酸钠注射液治疗,糠酸莫米松乳膏,多硫酸粘多糖乳膏可改善多形性红斑。从利伐沙班片改为华法林钠片后,红斑减少且没有恶化,并接受那洛肝素钙注射。
    Background: Limited data exists on the use of rivaroxaban for the treatment of pediatric patients. This report presents a case of probable rivaroxaban-induced Erythema Multiforme in Children. Case Summary: A female patient aged 5.5 years with antiphospholipid syndrome (APS) was administered oral rivaroxaban tablets 2.5 mg twice a day for 16 days. Subsequently, the patient developed a slight itching sensation on both feet and buttocks without an apparent cause. The following day, erythema multiforme appeared across the body in a scattered pattern. The erythema presented higher than the skin surface and partially merged into areas of the skin. Following an increase in the extent and degree of the erythema, all oral medications were ceased. Treatment with dexamethasone sodium phosphate injection, mometasone furoate cream, and mucopolysaccharide polysulfate cream resulted in an improvement of erythema multiforme. The erythema diminished and did not deteriorate subsequent to changing from rivaroxaban tablets to warfarin sodium tablets, and receiving nadroparin calcium injection.
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  • 文章类型: Case Reports
    背景:Rowell综合征(RS)是一种罕见的疾病,其特征是多形性红斑(EM)样病变和红斑狼疮。这在女性中更常见,EM可能是自身抗体阳性的疾病的第一个表现,例如抗核抗体(ANA),SSA,SSB和类风湿因子。RS的发病机制尚不清楚,可能是由药物诱导引起的。紫外线暴露和感染。
    方法:我们描述了一例来自中国的RS,表现为特征性的类目标样病变和手脚冻疮样红斑。这是皮肤科住院的女性患者的RS病例。
    结果:一名41岁女性,患有系统性红斑狼疮,四肢出现冻疮样红斑和特征性EM病变。她的血清ANA(1:320)和抗双链DNA检测呈阳性,以及其他自身抗体。全身性糖皮质激素和羟氯喹对她有效。
    结论:本病例符合RS的诊断标准。值得注意的是,同时出现面部蝴蝶红斑,在这种情况下,冻疮样红斑和EM病变分布在四肢上。
    Rowell syndrome (RS) is an uncommon condition characterized by erythema multiforme (EM)-like lesions and lupus erythematosus. It is more common in females, and EM may be the first manifestation of the disease with positive autoantibodies, such as antinuclear antibody (ANA), SSA, SSB and rheumatoid factor. The pathogenesis of RS is unknown and is likely caused by drug induction, ultraviolet exposure and infection.
    We describe a case of RS from China which presented as characteristic targetoid-like lesions and chilblain-like erythema on hands and feet. This is a case of RS in a female patient from the inpatient department of dermatology.
    A 41-year-old female with systemic lupus erythematosus exhibited chilblain-like erythema and characteristic EM lesions on her extremities. She tested positive for serum ANA (1:320) and anti-double-stranded DNA, as well as other autoantibodies. Systemic glucocorticoids and hydroxychloroquine worked effectively for her.
    The present case met diagnostic criteria of RS. Notably, there was a co-occurrence of facial butterfly erythema, chilblain-like erythema and EM lesions distributed on the limbs in this case.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    背景:爱泼斯坦-巴尔病毒(EBV)感染与多种疾病相关,可涉及多个器官和系统,临床表现复杂且无特异性,易误诊。以面颊部持续性多形性红斑(EM)为主要表现的慢性EBV感染非常罕见,鲜有报道。
    方法:本文报道1例女性慢性EBV感染,面部慢性对称性红斑病变4年,因畏光而加剧,流泪,过敏性紫癜(HSP)样皮疹,粒细胞和红细胞谱系下降,血尿,和蛋白尿1周。
    方法:该疾病最初被误诊为系统性红斑狼疮(SLE),后来通过皮肤活检证实为慢性EBV感染。在案件中,EBV感染不仅引起慢性面部EM,还可诱发急性HSP和紫癜性肾炎(血尿和蛋白尿型)。
    方法:患儿接受1周足量糖皮质激素联合阿昔洛韦抗病毒治疗和3次血液灌流治疗。放电后,患者口服醋酸泼尼松(15mg,每日2次)1个月后停药.
    结果:患者出院,皮疹缓解,血常规、尿常规正常。经过13个月的长期随访,她的面部红斑和色素沉着变得更轻,全身没有新的皮疹,全血细胞计数和尿检连续监测无异常。
    结论:此病例提示青少年女性患有慢性面部EM皮疹和多器官和系统损伤,需要警惕慢性EBV感染,除了结缔组织疾病如SLE。
    BACKGROUND: Epstein-Barr virus (EBV) infection is associated with a variety of diseases and can involve multiple organs and systems, with complex and nonspecific clinical manifestations that are easily misdiagnosed. Chronic EBV infection with persistent erythema multiforme (EM) on the cheek as the main manifestation is very rare and has been reported rarely.
    METHODS: This article reports a case of an adolescent female with chronic EBV infection who presented with chronic symmetrical erythema lesions on the face for 4 years, exacerbated with photophobia, lacrimation, Henoch-Schonlein purpura (HSP)-like rash, decline in granulocyte and erythrocyte lineages, hematuria, and proteinuria for 1 week.
    METHODS: The disease was initially misdiagnosed as systemic lupus erythematosus (SLE) and later confirmed as chronic EBV infection by skin biopsy. In the case, EBV infection not only caused chronic facial EM, but also induced acute HSP and purpura nephritis (hematuria and proteinuria type).
    METHODS: The child was treated with 1 week of glucocorticosteroids in adequate doses combined with acyclovir antiviral therapy and 3 sessions of hemoperfusion. After discharge, she took prednisone acetate (15 mg twice a day) orally for 1 month and then discontinued.
    RESULTS: She was discharged with her rash relieved and normal blood routine test and urine routine test. After 13 months of long-term follow-up, her facial erythema and hyperpigmentation became lighter, and there was no new rash on the whole body, and no abnormality in continuous monitoring of complete blood count and urine test.
    CONCLUSIONS: This case suggests the need to be alert for chronic EBV infection in adolescent females with chronic facial EM rash and multiple organs and systems injury, in addition to connective tissue diseases such as SLE.
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  • 文章类型: Review
    背景:5-氟尿嘧啶(5-FU)和放线菌素D(ActD)通常用于各种癌症的化学疗法。副作用在骨髓抑制中更常见,肝功能损害,和胃肠道反应。皮肤效应很少见,容易被医生和患者忽视,会导致危及生命的后果.
    方法:我们报道了一名45岁女性患者在5-FU和ActD化疗中出现皮肤红斑和指甲带。
    方法:多形性红斑药疹。
    方法:实验室检查包括血液和尿常规,肝肾功能,电解质和凝血功能并密切观察。
    结果:皮疹消失,指甲变化恢复。
    结论:延误诊断或治疗可能导致严重后果。我们应该注意5-FU和ActD的剂量,严格监测不良反应,减少皮肤恶性肿瘤的发生。
    BACKGROUND: 5-Fluorouracil (5-FU) and actinomycin D (ActD) are often used in chemotherapy for various cancers. Side effects are more common in bone marrow suppression, liver function impairment, and gastrointestinal responses. Skin effects are rare and easy to be ignored by doctors and patients, which can lead to life-threatening consequence.
    METHODS: We reported a 45-year-old woman patient developed skin erythema and fingernail belt in chemotherapy of 5-FU and ActD.
    METHODS: Erythema multiforme drug eruption.
    METHODS: Laboratory tests including blood and urine routine, liver and kidney function, electrolytes and coagulation function and close observation.
    RESULTS: The rash was gone and the nail change returned.
    CONCLUSIONS: Delays in diagnosis or treatment may lead to serious consequence. We should pay attention to the dosage of 5-FU and ActD, monitor adverse reactions strictly, to reduce occurrence of skin malignant events.
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  • 文章类型: Case Reports
    多形性红斑是一种广泛的超敏反应,其发病机制与多种因素有关,包括药物和病毒和细菌感染。确实,多形性红斑通常是由病毒引起的,而目前的研究表明,它主要与单纯疱疹病毒感染有关。很少与水痘-带状疱疹病毒感染有关。这里,我们报告一名50岁的男子因左侧肋骨出现皮疹并疼痛9天,四肢和手部出现皮疹2天而入院。实验室数据显示,通过定性聚合酶链反应,血液中的水痘-带状疱疹病毒(VZV-DNA)检测为阴性。带状疱疹病毒IgM(VZV-IgM)酶联免疫吸附试验阴性,和带状疱疹病毒IgG(VZV-IgG)酶联免疫吸附试验阳性。诊断为带状疱疹和多形性红斑。抗病毒治疗后,抗过敏,和局部药物,皮疹明显改善。我们的病例报告有助于多形性红斑的发病机理。
    Erythema multiforme is a widespread hypersensitivity reaction, its pathogenesis is related to a variety of factors, including drugs and viral and bacterial infections. It is true that erythema multiforme is often caused by viruses while current studies suggest that it is mostly associated with herpes simplex virus infection, rarely associated with varicella-zoster virus infection. Here, we report a 50-year-old man admitted to our hospital because of rashes on the left rib with pain for 9 days and on limbs and hands for 2 days. Laboratory data showed that varicella-zoster virus (VZV-DNA) test was negative in blood by qualitative polymerase chain reaction. Herpes zoster virus IgM (VZV-IgM) enzyme linked immune sorbent assay was negative, and herpes zoster virus IgG (VZV-IgG) enzyme linked immune sorbent assay was positive. Herpes zoster and erythema multiforme was diagnosed. After treatment with antiviral, antiallergic, and topical drugs, the rashes was significantly improved. Our case report contributes to the pathogenesis of erythema multiforme.
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