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[药物引起的皮肤不良反应]

[Adverse cutaneous reactions to drugs].

作者信息

Suástegui-Rodríguez Irvin, Campos-Jiménez Karin Ivette, Domínguez-Cherit Judith, Méndez-Flores Silvia

机构信息

Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México.

Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México

出版信息

Rev Med Inst Mex Seguro Soc. 2018 Jan-Feb;56(1):64-70.

Abstract

Adverse cutaneous reactions to drugs are any undesirable change in the structure or function of the skin. These are among the adverse side effects to common drugs. The most commonly implicated drugs are antibiotics and anticonvulsants. Cutaneous clinical manifestations are diverse ranging from mild or moderate reactions, such as urticaria and maculopapular rash, to severe cutaneous adverse reactions (SCAR), which are known due to their high morbidity and mortality (among these: Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). The clinical pattern, etiology, prognosis and treatment differ among these skin reactions, which is why it is necessary a clear diagnosis based on a comprehensive clinical examination, skin biopsy, and specific laboratory tests. The therapeutic options depend on the clinical diagnosis. For all reactions, a symptomatic and adequate supportive therapy is necessary; in some cases, a systemic immunomodulatory therapy can be useful.

摘要

药物引起的皮肤不良反应是指皮肤结构或功能出现的任何不良变化。这些属于常见药物的不良副作用。最常涉及的药物是抗生素和抗惊厥药。皮肤临床表现多种多样,从轻或中度反应,如荨麻疹和斑丘疹,到严重的皮肤不良反应(SCAR),后者因其高发病率和死亡率而为人所知(其中包括史蒂文斯-约翰逊综合征、中毒性表皮坏死松解症(TEN)以及伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS))。这些皮肤反应在临床模式、病因、预后和治疗方面各不相同,这就是为什么有必要基于全面的临床检查、皮肤活检和特定实验室检查进行明确诊断。治疗选择取决于临床诊断。对于所有反应,对症且充分的支持治疗是必要的;在某些情况下,全身免疫调节治疗可能会有用。

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