【摘 要】
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患者,男,54岁.2000年10月份左踝部肿痛,在骨科诊断为“痛风”,给予别嘌呤醇片口服.11月1日开始全身出现弥漫性鲜红色斑,密集对称分布,压之褪色,皮损之间见正常皮肤.11月12日
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患者,男,54岁.2000年10月份左踝部肿痛,在骨科诊断为“痛风”,给予别嘌呤醇片口服.11月1日开始全身出现弥漫性鲜红色斑,密集对称分布,压之褪色,皮损之间见正常皮肤.11月12日来我科就诊,无恶心、畏寒、低热等.皮肤科情况:头皮大面积渗出性斑片及浆痂,面部皮肤肿胀潮红,鼻周见渗出性浆痂.躯干、四肢皮肤潮红、浸润、肿胀明显,少量脱屑.体检:血压120/80mmHg,心跳、呼吸正常,淋巴结无肿大,肝、脾未肿大.实验室检查:白细胞19.6×109/L,嗜中性白细胞84%,嗜酸性白细胞计数2728×106/L(正常300×106/L以下).诊断:别嘌呤醇致红皮病型药疹.治疗经过:甲基强的松龙40mg加入5%葡萄糖液500ml分两次静脉点滴,红霉素静脉点滴防止感染.并应用强的松10 mg每日3次,连续10d.治疗中血糖升高至7.3 mmol/L,激素减量后即降至正常.
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