Drug eruption - Lægemiddeludbrud
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Lægemiddeludbrud (Drug eruption) er kendetegnet ved at påvirke hele kroppen.
References
Hudreaktioner forårsaget af medicin, kendt som lægemiddeludbrud, kan nogle gange være alvorlige. Disse alvorlige reaktioner, kaldet severe cutaneous adverse drug reactions (SCARs) , betragtes som livstruende. De inkluderer betingelser som Stevens-Johnson syndrome (SJS) , toxic epidermal necrolysis (TEN) , acute generalized exanthematous pustulosis (AGEP) , and drug reaction with eosinophilia and systemic symptoms (DRESS) . Mens SCARs er sjældne, oplever omkring 2 % af indlagte patienter dem.
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.
En 31-årig kvinde besøgte dermatologisk afdeling med et smertefrit rødt plet øverst på højre fod. Hun tog en dosis doxycyclin (100 mg) dagen før, efter picosecond laserbehandling for acne ar. Sidste år oplevede hun et lignende problem på samme sted efter at have taget den samme dosis doxycyclin efter laserbehandling. Hun har ingen væsentlig sygehistorie og ingen andre symptomer, såsom feber, lokalt eller i hele kroppen.
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) og toxic epidermal necrolysis (TEN) er to former for en alvorlig hudreaktion, der adskiller sig fra andre hudsygdomme såsom erythema multiforme major og stafylokokker skoldet hud-syndrom, såvel som lægemiddelreaktioner. SJS/TEN er en sjælden og alvorlig reaktion, der forårsager udbredt hud- og slimhindeskade, ofte med systemiske symptomer. I over 80% af tilfældene er medicin årsagen.
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.
Lægemiddeludbrud diagnosticeres hovedsageligt ud fra sygehistorien og klinisk undersøgelse. En hudbiopsi, blodprøver eller immunologiske tests kan også være nyttige.
Eksempler på almindelige lægemidler, der forårsager udbruddet, er antibiotika og andre antimikrobielle lægemidler, sulfa-lægemidler, ikke-steroide antiinflammatoriske lægemidler (NSAID), kemoterapimidler til maligniteter, antikonvulsiva og psykotrope lægemidler.
○ Diagnose og behandling
Hvis du har feber (forhøjet kropstemperatur), bør du søge læge hurtigst muligt. Det mistænkte lægemiddel bør seponeres (f.eks. antibiotika, ikke-steroide antiinflammatoriske lægemidler). Før du besøger hospitalet, kan orale antihistaminer såsom cetirizin eller loratadin hjælpe mod kløe og udslæt.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]
Blodprøve (CBC, LFT, eosinofiltal)
Orale steroider og antihistaminer efter lægeordination