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病例,男,30岁,四肢末端及背部出现虹膜样红斑伴瘙痒8天入院。8天前因感冒服克感敏;两天后手足及背部出现虹膜样红斑,自觉瘙痒,经地塞米松治疗两天无效到我院就诊。入院检查:一般情况好,系统检查无异常发现。入院诊断为多形性红斑型药疹,给与甲基强的松龙40mg/d静脉滴注治疗。治疗中发现病人四肢浅静脉均已破坏,静脉穿刺极为困难,为此询问病人家属后得知病人有吸毒史10年,其中静脉注射毒品史8年,现戒断5个月。查血清HIV抗体阳性,送云南省卫生防疫站确诊试验阳性。治疗中红斑增多并出现新发水疱,瘙痒加重,病情恶化。由于四肢浅静脉穿刺困难,进行股静脉穿刺输液,甲基强的松龙剂量增加到 80mg/d同时抗感染及加强支持治疗,病情仍未控制,躯干四肢继续出现水疱及大疱,
Case, male, 30 years old, extremities and back with iris erythema with itching 8 days admitted. 8 days ago due to cold flu grams sensitive; hands and feet and back two days after the occurrence of iris-like erythema, conscious itching, dexamethasone two days invalid treatment to our hospital. Admission examination: the general situation is good, no abnormal system checks found. Admitted to diagnosis of erythema multiforme type drug eruption, given methylprednisolone 40mg / d intravenous infusion therapy. Treatment found that patients with superficial veins have been destroyed limbs, venipuncture is extremely difficult to ask the patient’s family after the patient was informed of drug abuse history of 10 years, including intravenous drug history for 8 years, is now withdrew for 5 months. Serum HIV antibody positive, sent to the Yunnan Provincial Health and Epidemic Station confirmed positive test. Treatment of erythema increased and the emergence of new blisters, itching aggravated, the condition deteriorated. Due to the difficulty of puncturing the superficial veins in the extremities, femoral vein puncture infusion and the dosage of methylprednisolol increased to 80mg / d while anti-infection and supportive care were strengthened. The condition was still not controlled. The blisters and bullae continued to appear on the trunk and limbs,