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杨××,女性,29岁。诊断:慢性肾炎、尿毒症,于1979年9月10日起维持血透治疗。同年12月29日因血尿酸达9毫克％而开始服用别嘌呤醇300毫克/日。服药第十二天,自觉皮肤瘙痒,并出现红色斑丘疹,5天后出现上消化道出血和全身皮疹加剧,呈广泛暗红斑,皮肤干皱,面颈部有大小不一的松弛水泡,伴口腔粘膜、眼结膜破溃。诊断为中毒性表皮坏死松解症。即停用别嘌呤醇,给地塞米松10毫克/日治疗。4天后皮疹色泽转暗,并见部分消退,下颌水泡干涸,表皮有脱落,口腔溃疡好转。但血尿素氮急剧上升达130毫克％,血肌酐26.5毫克％,口腔霉菌感染。因此第五天起将地塞米松减为7.5毫克/日,并给予紧急血透及抗霉菌治疗.当地塞米松减量到2.5毫克/日时,患者手掌、足趾又出现新泡疹并伴高热、咳嗽、黄痰、两肺湿性罗音。随即地塞米松又加到10毫克/日,并同时给予氯霉素琥珀酸钠3克/日及白霉素400毫克/
Yang × ×, female, 29 years old. Diagnosis: Chronic nephritis, uremia, on September 10, 1979 to maintain hemodialysis treatment. December 29 the same year due to blood uric acid up to 9 mg% and started taking allopurinol 300 mg / day. On the 12th day of taking medicine, it was pruritus and red rash appeared. After 5 days, upper gastrointestinal bleeding and systemic rash were exacerbated. There were extensive dark red spots, dry skin folds, loose blisters of different sizes on face and neck, Mucosa, conjunctival ulceration. Diagnosis of toxic epidermal necrolysis. That disables allopurinol, dexamethasone 10 mg / day treatment. After 4 days, the color of the rashes turned dark, and see some of the subsided, dry jaws, epidermis shedding, oral ulcers improved. But blood urea nitrogen rose sharply up to 130 mg%, serum creatinine 26.5 mg%, oral mold infection. Therefore, dexamethasone was reduced to 7.5 mg / day on the fifth day and given an emergency hemodialysis and anti-mold treatment. When dexamethasone was reduced to 2.5 mg / day, a new skin rash appeared along the palms and toes of the patient High fever, cough, yellow sputum, lung wet rales. Then dexamethasone and added to 10 mg / day, and at the same time give chloramphenicol sodium succinate 3 g / day and white mold 400 mg /