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題名 | Clinical Characteristics of Childhood Erythema Multiforme, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Taiwanese Children=臺灣兒童多型性紅斑,史蒂芬-強生症候群及表皮壞死性皮膚炎之臨床特徵 |
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作者 | 林雅璇; 楊謹旭; 王麗潔; 林于粲; 江伯倫; | 書刊名 | 微免與感染雜誌 |
卷期 | 37:6 2004.12[民93.12] |
頁次 | 頁366-370 |
分類號 | 417.56 |
關鍵詞 | 兒童; 多型性紅斑; 史蒂芬-強生症候群; 表皮壞死性皮膚炎; Erythema multiforme; Stevens-johnson syndrome; Toxic epidermal necrolysis; Treatment outcome; |
語文 | 英文(English) |
英文摘要 | Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are mucocutaneous diseases associated with significant morbidity and mortality. This study compared childhood EM, SJS and TEN in terms of clinical courses, laboratory data, etiologies and outcomes in Taiwan. The initial laboratory findings, clinical presentations, etiologies and subsequent clinical courses of 30 patients with a diagnosis of EM, SJS or TEN, who were admitted between 1995 and 2003 at National Taiwan University Hospital were included and analyzed. There were 19 cases of EM, 8 cases of SJS, 2 cases of SJS/TEN and 1 case of TEN. The most common etiology in EM was infection (84.2%), and the most common implicated organism was Mycoplasma pneumoniae (42.1%). In contrast, 75% of SJS and 100% of TEN were induced by drugs. The most common offending drug was carbamazepine. Those patients with underlying diseases had more protracted courses and longer hospitalization stays. No mortalities were found in our cases. Early short-term steroid equivalent to 1-2 mg/kg/day of prednisolone for 3-5 days was used in 87.5% of SJS patients, without any significant side effects. Those with poor responsiveness to steroids and protracted courses were treated with additional intravenous immunoglobulin (IVIG) [1 g/kg/day], with satisfactory results. Early ophthalmic consultations were performed in all cases. No ocular complications were found in our cases. In conclusion, EM, SJS and TEN were associated with significant morbidity. Early ophthalmic consultations and withdrawal of the offending medication was necessary. Early short-term use of steroids in SJS showed promising results without significant side effects. The additional IVIG in those who had a poor response to steroid treatment may be helpful. |
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