Drug eruption
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Drug eruption es caracteritza per afectar tot el cos.
References
Les reaccions cutànies causades per medicaments, conegudes com a erupcions de drogues, de vegades poden ser greus. Aquestes reaccions greus, anomenades severe cutaneous adverse drug reactions (SCARs) , es consideren potencialment mortals. Inclouen condicions com Stevens-Johnson syndrome (SJS) , toxic epidermal necrolysis (TEN) , acute generalized exanthematous pustulosis (AGEP) , and drug reaction with eosinophilia and systemic symptoms (DRESS) . Tot i que SCARs són rars, al voltant del 2% dels pacients hospitalitzats els experimenten.
Adverse drug reactions involving the skin are commonly known as drug eruptions. Severe drug eruption 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), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Although cases are relatively rare, approximately 2% of hospitalized patients are affected by SCARs.
Adverse drug reactions involving the skin are commonly known as drug eruptions. Severe drug eruption 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), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Although cases are relatively rare, approximately 2% of hospitalized patients are affected by SCARs.
Una dona de 31 anys va visitar el departament de dermatologia amb una taca vermella indolora a la part superior del peu dret. Va prendre una dosi de doxiciclina (100 mg) el dia abans, després del tractament amb làser de picosegons per a les cicatrius d'acne. L'any passat, va experimentar un problema similar al mateix lloc després de prendre la mateixa dosi de tractament post-làser de doxiciclina. No té antecedents mèdics significatius ni cap altre símptoma, com ara febre, a nivell local o a tot el seu cos.
A 31-year-old woman presented to the dermatology department with an asymptomatic erythematous patch on the dorsum of her right foot. She had taken 1 dose of doxycycline (100 mg) the previous day as empirical treatment after picosecond laser treatment for acne scars. She had had a similar episode the previous year on the same site, after taking the same dose of doxycycline after laser treatment. She had no notable medical history, and no other local or systemic symptoms, including fever.
A 31-year-old woman presented to the dermatology department with an asymptomatic erythematous patch on the dorsum of her right foot. She had taken 1 dose of doxycycline (100 mg) the previous day as empirical treatment after picosecond laser treatment for acne scars. She had had a similar episode the previous year on the same site, after taking the same dose of doxycycline after laser treatment. She had no notable medical history, and no other local or systemic symptoms, including fever.
Stevens-Johnson syndrome (SJS) i toxic epidermal necrolysis (TEN) són dues formes de reacció cutània greu, diferents d'altres afeccions de la pell com l'eritema multiforme major i la síndrome de la pell escaldada per estafilocòc, així com les reaccions als medicaments. SJS/TEN és una reacció rara i greu que causa danys generalitzats a la pell i les mucoses, sovint amb símptomes sistèmics. En més del 80% dels casos, els medicaments són la causa.
Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) are variants of the same condition and are distinct from erythema multiforme major staphylococcal scalded skin syndrome, and other drug eruptions. Stevens-Johnson syndrome/toxic epidermal necrolysis is a rare, acute, serious, and potentially fatal skin reaction in which there are sheet-like skin and mucosal loss accompanied by systemic symptoms. Medications are causative in over 80% of cases.
Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) are variants of the same condition and are distinct from erythema multiforme major staphylococcal scalded skin syndrome, and other drug eruptions. Stevens-Johnson syndrome/toxic epidermal necrolysis is a rare, acute, serious, and potentially fatal skin reaction in which there are sheet-like skin and mucosal loss accompanied by systemic symptoms. Medications are causative in over 80% of cases.
Les erupcions de drogues es diagnostiquen principalment a partir de la història clínica i l'examen clínic. També poden ser útils una biòpsia de la pell, anàlisis de sang o proves immunològiques.
Exemples de fàrmacs comuns que causen l'erupció són els antibiòtics i altres fàrmacs antimicrobians, fàrmacs sulfa, antiinflamatoris no esteroides (AINE), agents de quimioteràpia per a malalties malignes, anticonvulsivants i psicotròpics.
○ Diagnòstic i tractament
Si tens febre (augment de la temperatura corporal), has de buscar atenció mèdica el més aviat possible. S'ha de suspendre el medicament sospitós (per exemple, antibiòtics, antiinflamatoris no esteroides). Abans d'anar a l'hospital, els antihistamínics orals com la cetirizina o la loratadina poden ajudar a la picor i l'erupció.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]
Anàlisi de sang (CBC, LFT, recompte d'eosinòfils)
Esteroides orals i antihistamínics amb recepta mèdica