The Clinical Analysis Of25Cases Of Severe Drug Eruption

Objective: To know the clinical feature of Stevens-Johnson syndrome,Drug-inducedbullosa epidermolysis,drug-induced exfoliative dermatitis,analyze the causativedrugs,summarize the treatment experience,factors related to the prognosis of severedrug eruption.6Methods: A retrospective analysis was carried out on the clinical data of25patientssuffered from severe drug eruption and admitted in our hospital from January2002toDecember2013.The control standard of judging disease:no new rash,the original rashbecome dark,exudatum reduction,Blister wall close to the basal,Nikolsky sign(-),thebody temperature deceased to normal,the symptoms,such as itch,pain,significantlyreduced.SPSS statistical package and chi square test or Fisher’s test or t test or rank sumtest was used,so p<0.05was believed to show statistical significance.Results:There were25patients who experienced severe drug eruption.Among them，there were11cases of erythema multiforme major(44%),8cases of toxic epidermalnecrolysis(32%) and6cases of exfoliative dermatitis(24%).the top three of thesepredominant causative drugs is antibiotics(40%),antipyretics and analgesics(24%)、Chinese drugs pharmaceutics(20%);the history of drug allergy(44%),Severe drugeruption with chronic allergic history(56%),inhalant allergy history(12%).Above51years old had the highest incidence(52%) and the older the worse prognosis.Moreman(64%) the women(36%).Route of medicine is mainly oral(68%).The shortestlatency of30minutes,the longest49days,an average of12.38days.The newly starteddrug,latency was longer than again (t=2.83,p<0.05).the latency of ED is significantlylonger than TEN and SJS (F=10.74,p<0.05). Mucosal involvement of SJS had the highest incidence,ED group had the lowest,Among them,the most common oralmucosal membrane(84%).In addition to the serious damage of skin mucous membraneoften accompanied by systemic symptoms,fever in96﹪,blood abnormalities in92﹪,hypoproteinemia in64%,water and electrolyte disorders in76%etc.Organinvolvement mainly in the liver(68%),the kidney(52%),the heart(25%);TEN is moreprone to complications,the difference has statistical significance(F=9.35,p<0.05).Glucocorticoiddosage in TEN is the largest,compared with SJS and ED had significantdifference((F=4.13,P<0.05).The hospitalization time of SJS is the shortest,comparedwith TEN and ED had statistically significant difference(t=2.94,t=3.07,p<0.05).Diseasecontrol of severe drug eruption and age,types of drug eruptions,skin and mucousmembrane damage,timely and effective treatment is relevant.Conclusions:The most common severe drug eruption is SJS,but TEN is the heaviestand prone to complications.Pay attention to,drug eruptions induced traditional Chinesemedicine increase obviously and is neglected in clinical.Immediately stop all suspecteddrug, early and adequate use of glucocorticoid is the key to successful treatment ofsevere drug eruption,invalid high dose glucocorticoid therapy, combined with large doseof immunoglobulin is the best choice for treatment of severe drug eruption.Strengthenthe support therapy and skin mucosa care can reduce complications, sequelae.It issuggested that the prognosis is determined by the age of the patient, underlying diseases,the type of drug eruption, the involving scopes of the skin and mucosa, whethercomplicated by visceral damage.timely stoping causative drug and Early standardizedtreatment.