Drug eruption - Letusan Dadah
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Letusan Dadah (Drug eruption) dicirikan dengan menjejaskan seluruh badan.
References
Reaksi kulit yang disebabkan oleh ubat, yang dikenali sebagai letusan dadah, kadangkala boleh menjadi teruk. Reaksi teruk ini, dipanggil severe cutaneous adverse drug reactions (SCARs) , dianggap mengancam nyawa. Ia termasuk syarat seperti Stevens-Johnson syndrome (SJS) , toxic epidermal necrolysis (TEN) , acute generalized exanthematous pustulosis (AGEP) , and drug reaction with eosinophilia and systemic symptoms (DRESS) . Walaupun SCARs jarang berlaku, sekitar 2% pesakit dimasukkan ke hospital mengalaminya.
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.
Seorang wanita berusia 31 tahun melawat bahagian dermatologi dengan tompok merah yang tidak menyakitkan di bahagian atas kaki kanannya. Dia mengambil satu dos doxycycline (100 mg) sehari sebelumnya, selepas rawatan laser picosecond untuk parut jerawat. Tahun lepas, dia mengalami masalah yang sama di tempat yang sama selepas mengambil dos rawatan pasca laser doxycycline yang sama. Dia tidak mempunyai sejarah perubatan yang ketara dan tiada gejala lain, seperti demam, secara tempatan atau di seluruh badannya.
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) dan toxic epidermal necrolysis (TEN) ialah dua bentuk tindak balas kulit yang serius, berbeza daripada keadaan kulit lain seperti erythema multiforme major dan sindrom kulit melecur staphylococcal, serta tindak balas dadah. SJS/TEN ialah tindak balas yang jarang berlaku dan teruk menyebabkan kerosakan kulit dan membran mukus yang meluas, selalunya dengan gejala sistemik. Dalam lebih 80% kes, ubat adalah puncanya.
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.
Letusan dadah didiagnosis terutamanya daripada sejarah perubatan dan pemeriksaan klinikal. Biopsi kulit, ujian darah atau ujian imunologi juga boleh berguna.
Contoh ubat biasa yang menyebabkan letusan ialah antibiotik dan ubat antimikrob yang lain, ubat sulfa, ubat antiradang bukan steroid (NSAID), agen kemoterapi untuk keganasan, antikonvulsan dan ubat psikotropik.
○ Diagnosis dan Rawatan
Jika anda mengalami demam (suhu badan meningkat), anda perlu mendapatkan rawatan perubatan secepat mungkin. Ubat yang disyaki harus dihentikan (cth. antibiotik, ubat anti-radang bukan steroid). Sebelum melawat hospital, antihistamin oral seperti cetirizine atau loratadine boleh membantu untuk gatal-gatal dan ruam.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]
Ujian darah (CBC, LFT, kiraan eosinofil)
Steroid oral dan antihistamin dengan preskripsi doktor