Toxic epidermal necrosis - 中毒性表皮坏死
特色脱皮中毒性表皮坏死 (Toxic epidermal necrosis)
relevance score : -100.0%
ReferencesStevens-Johnson Syndrome (SJS) 和 Toxic Epidermal Necrolysis (TEN) 是皮肤出现大面积坏死和脱落的罕见疾病。治疗上，环孢素对 SJS 疗效显著；而静脉注射免疫球蛋白 (IVIg) 与皮质类固醇联合使用，则是 SJS 与 TEN 病例中最有效的方案。
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN.
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN.
Toxic epidermal necrolysis (TEN) 是由某些药物和免疫系统活动引起的严重皮肤反应，导致表皮大规模脱落，累及超过30%的体表面积。TEN 的死亡率超过20%，主要因感染和呼吸困难。停用致病药物、给予支持性护理并采用额外治疗可改善预后。最新研究基于随机对照试验和多项分析，提示环孢素、肿瘤坏死因子α抑制剂以及静脉注射免疫球蛋白与皮质类固醇联合使用可能有益。
Toxic epidermal necrolysis (TEN) is a serious skin reaction caused by certain medications and immune system activity, resulting in large-scale detachment of the outer skin layer (epidermis), affecting more than 30% of the body's surface. TEN has a mortality rate of over 20%, often due to infections and breathing difficulties. Stopping the medication causing the reaction, providing supportive care, and using additional treatments can improve the outcome. Recent studies have shown that drugs like cyclosporine, tumor necrosis factor alpha inhibitors, and a combination of intravenous immune globulin and corticosteroids can be helpful, based on randomized controlled trials and analyses of multiple studies.
Toxic epidermal necrolysis (TEN) is a serious skin reaction caused by certain medications and immune system activity, resulting in large-scale detachment of the outer skin layer (epidermis), affecting more than 30% of the body's surface. TEN has a mortality rate of over 20%, often due to infections and breathing difficulties. Stopping the medication causing the reaction, providing supportive care, and using additional treatments can improve the outcome. Recent studies have shown that drugs like cyclosporine, tumor necrosis factor alpha inhibitors, and a combination of intravenous immune globulin and corticosteroids can be helpful, based on randomized controlled trials and analyses of multiple studies.
Recent Advances: There is improved understanding of pain and morbidity with regard to the type and frequency of dressing changes. More modern dressings, such as nanocrystalline, are currently favored as they may be kept in situ for longer periods. The most recent evidence on systemic agents, such as corticosteroids and cyclosporine, and novel treatments, are also discussed.
最常见的诱因是某些药物，如 lamotrigine(拉莫三嗪)、carbamazepine(卡马西平)、allopurinol(别嘌呤醇)、sulfonamide antibiotics(磺胺类抗生素)和 nevirapine(奈韦拉平)。危险因素包括艾滋病毒感染和系统性红斑狼疮。治疗通常在医院进行，如烧伤科或重症监护室。
○ 治疗
该疾病危重，如出现口唇或口腔受累、皮肤起水泡，请及时就医。应立即停用可疑药物（如抗生素、非甾体抗炎药）。