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1例57岁男性患者因脑外伤继发癫痫服用卡马西平0.1 g,2次/d。12 d后,患者躯干部出现紫红色斑片,迅速扩张至面、颈部,同时口腔、眼、外生殖器的皮肤、黏膜出现糜烂,伴有高热。停用卡马西平。2 d后在红斑部位出现水疱,水疱破溃后形成糜烂面。诊断为卡马西平致中毒性表皮坏死松解症。予以甲泼尼龙、头孢孟多酯钠、复方甘草酸苷、还原型谷胱甘肽、多烯磷脂酰胆碱、人免疫球蛋白等治疗。患者皮疹逐渐好转,1个月后糜烂面基本痊愈。
One 57-year-old male patient received carbamazepine 0.1 g twice daily for epilepsy due to traumatic brain injury. Twelve days later, the patient’s torso appeared purple patches, rapid expansion to the face, neck, mouth, eyes, genital skin, mucosal erosion, accompanied by fever. Disable carbamazepine. 2 days after the blisters appear in the erythema, blisters collapse after the formation of erosion surface. Diagnosis of carbamazepine induced toxic epidermal necrolysis. To methylprednisolone, cephalexin sodium, compound glycyrrhizin, reduced glutathione, polyene phosphatidylcholine, human immunoglobulin and other treatment. Patient rash gradually improved, 1 month after the erosion surface basically recovered.