의대 본과 4학년 PK과제 SJS를 잘 유발하는 약물
분야
hwp1.Drugs
2.Major cause : TEN의 80~90%, SJS의 50% 이상
3.Sulfa : sulfonamide, co-trimoxazole
4.Anticonvulsant : carbamazepine, lamotrigine
5.NSAIDs : butazone, oxicam
6.Acetaminophen
7.Antimalarials, Allopurinol, Chlomezone, 항결핵제
8.소아 : hydantoin이 TEN의 주원인
1.SSSS의 histologic finding
All forms of scalded skin syndrome are characterized by intraepidermal cleavage, with splitting that occurs beneath and within the stratum granulosum. The cleavage space may contain free-floating or partially attached acantholytic cells. The remainder of the epidermis appears unremarkable, and the dermis contains no inflammatory cells.
표피 하 가시세포 해리, 표피 전층 , 상부 진피에 염증 세포 없음.
2.SJS의 histologic finding
The earliest histologic finding in SJS is a perivascular mononuclear inflammatory infiltrate comprised primarily of T-lymphocytes [76,77]. This infiltrate is not diagnostic, and it may be seen in a wide variety of conditions, including a simple drug-induced exanthem. A sparse infiltrate of lymphocytes develops at the dermoepidermal junction, with lymphocytes clustered around dying basal keratinocytes ("satellitosis") [9]. As the lesions progress, frank subepidermal vesiculation develops, with full thickness epidermal necrosis.
Reference
-Color Atlas and Synopsis of Clinical Dermatology: Common and Serious Diseases, 3rd edition, Fitzpatrick, TB, Johnson, RA, Wolff, K, et al (Eds), McGraw-Hill, New York 1997.
-Dermatology 5th edition ; 대한피부과학회
-Harrisons principles of Internal Medicine, 17th edition, Mcgraw Hill
-Bocquet H, Bagot M, Roujeau JC (December 1996). "Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS)". Semin Cutan Med Surg 15 (4): 250-7.
-Ghislain PD, Roujeau JC. Treatment of severe drug reactions: Stevens-Johnson syndrome, toxic epidermal necrolysis and hypersensitivity syndrome. Dermatol Online J. 2002 Jun;8(1):5.
-Saltzstein SL, Ackerman LV (1959). "Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically pathologically malignant lymphomas". Cancer 12 (1): 164-82. doi:10.
-Allam, JP; Paus T, Reichel C et al. (Sep-Oct 2004). "DRESS syndrome associated with carbamazepine and phenytoin". European Journal of Dermatology 14 (5): 339-342.
