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Érythème pigmenté fixe bulleux généralisé : à propos d’un cas 全身性大疱性色素沉着性红斑:关于一个病例
IF 0.3 4区 医学 Pub Date : 2025-09-01 Epub Date: 2025-03-31 DOI: 10.1016/j.reval.2025.104554
L. Elyamani , N. Benaini , O. Hormi , N. Zerrouki , N. Zizi

Introduction

Generalized bullous fixed drug eruption is a rare and severe form of fixed drug eruption, often induced by cotrimoxazole, which may be confused with Stevens-Johnson syndrome.

Observation

A 45-year-old patient with no relevant history developed Generalized bullous fixed drug eruption 8 hours after taking cotrimoxazole for gastroenteritis. A similar episode localized to the extremities had been reported 5 years earlier, occurring 4 days after taking the same drug. Clinico-pathological correlation led to the diagnosis of Generalized bullous fixed drug eruption. Treatment consisted of discontinuation of cotrimoxazole and local care, resulting in healing of all lesions, with post-inflammatory hyperpigmentation. Reintroduction of the drug was prohibited, and a pharmacovigilance report was made.

Discussion

Fixed drug eruption is a drug-induced toxidermia characterized by well-limited skin lesions, recurring at the same site after re-exposure to the causative drug. Generalized bullous fixed drug eruption is a rare and severe form, which can mimic Stevens-Johnson syndrome/toxic epidermal necrolysis, particularly in cases of extensive mucosal involvement. Diagnosis is based on clinico-pathological correlation and a detailed drug history. Treatment consists of discontinuing the causative drug, combined with local care. Topical or systemic corticosteroids may be necessary in severe forms.

Conclusion

Erythema pigmentosum fixed bullosa generalizada (EPFBG) is a rare and misunderstood condition. Further efforts are needed to develop more reliable and safer methods for identifying the drugs involved in equivocal situations.
广泛性大疱性固定药疹是一种罕见而严重的固定药疹,常由复方新诺明引起,可能与Stevens-Johnson综合征混淆。患者45岁,无相关病史,服用复方新诺明治疗胃肠炎8小时后出现全身性大疱性固定药疹。5年前曾报道过类似的肢体局部发作,发生在服用相同药物后4天。临床病理结合诊断为广泛性大疱性固定药疹。治疗包括停用复方新诺明和局部护理,导致所有病变愈合,炎症后色素沉着。禁止重新使用该药物,并编写了一份药物警戒报告。固定药疹是一种药物引起的氧化血症,其特征是皮肤损伤有限,在再次暴露于致病药物后在同一部位复发。全身性大疱性固定药疹是一种罕见且严重的形式,可模拟Stevens-Johnson综合征/中毒性表皮坏死松解,特别是在广泛累及粘膜的情况下。诊断是基于临床病理相关性和详细的用药史。治疗包括停用致病性药物,并结合局部护理。在严重的情况下,局部或全身使用皮质类固醇是必要的。结论广泛性固定大疱性色素红斑(EPFBG)是一种罕见且易被误解的疾病。需要进一步努力开发更可靠和更安全的方法,以确定在模棱两可的情况下所涉及的药物。
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引用次数: 0
Assessing allergenicity of urban parks: Ordu City 城市公园致敏性评估:奥尔都市
IF 0.3 4区 医学 Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI: 10.1016/j.reval.2025.104582
S. Türkiş , F.E. Günaydin
Higher average temperatures due to climate change tend to change the spatial and temporal distribution of pollens. The study area was conducted in the Urban Park areas of Ordu Province, where urban people spend the most time. In the last decade, various allergenicity indices such as Specific Allergenicity Index (SAI) and Urban Green Zone Allergenicity Index (IUGZA) have been proposed to control hypoallergenicity in urban areas. The study aimed to warn allergic individuals about the risk posed by pollens and evaluate the allergenicity of existing urban vegetation. Specific Allergenicity Index (SAI) and Urban Green Zone Allergenicity Indexes (IUGZA = 0.208) of 25 plant species spread in urban park areas were calculated. To determine these indices, life cycle, overlap-abundance values, height, pollination time, pollination process, allergenicity potential, and cross-reactivity values of the species were determined. Among the species, the species with the highest allergenic effect, i.e. both abundance and allergenic potential, is Corylus avellana var avellana. In terms of allergenic potential value (VPA), it is seen that C. avellana var. avellana, Alnus glutinosa, Cupressus sempervirens, Olea europae, Salix spp. and Acer spp. are the most effective species on the axes. The abundance of the species (0.802) was the factor that made the allergenic factors most effective. Determination of the urban allergenicity index of Ordu province to determine the ecological driving forces of the distribution of ecosystems is important in estimating the allergenicity index of urban green areas and in selecting the right species to minimize the allergenic in parks.
气候变化导致的平均气温升高往往会改变花粉的时空分布。研究区域是在Ordu省的城市公园区域进行的,那里是城市居民花费最多时间的地方。近十年来,人们提出了各种过敏原指数,如特异性过敏原指数(SAI)和城市绿区过敏原指数(IUGZA),以控制城市地区的低过敏原性。本研究旨在警示过敏个体花粉的风险,并评估现有城市植被的致敏性。计算了分布在城市公园区域的25种植物的特异性致敏性指数(SAI)和城市绿区致敏性指数(IUGZA = 0.208)。为了确定这些指标,测定了物种的生命周期、重叠丰度值、高度、授粉时间、授粉过程、致敏潜力和交叉反应性值。其中,致敏效应(即丰度和致敏潜力)最高的物种是Corylus avellana var avellana。从致敏潜值(VPA)来看,在轴上最有效的树种是黄樟(C. avellana var. avellana)、桤木(Alnus glutinosa)、柏树(perpressus sempervirens)、油橄榄(Olea europae)、柳树(Salix)和槭(Acer)。物种丰度(0.802)是使致敏因子最有效的因素。确定奥尔都省城市变应原指数,确定生态系统分布的生态驱动力,对于估算城市绿地的变应原指数和选择合适的物种以减少公园的变应原具有重要意义。
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引用次数: 0
L’allergie à l’arachide. État des lieux et perspectives, par le GT2A. Partie 1 : épidémiologie et fardeau de l’allergie à l’arachide 对花生过敏。状态和前景,由GT2A。第一部分:花生过敏的流行病学和负担
IF 0.3 4区 医学 Pub Date : 2025-09-01 Epub Date: 2025-08-16 DOI: 10.1016/j.reval.2025.104567
G. Pouessel , A. Deschildre , F. Amat , M. Morisset , V. Jubin , pour le Groupe de travail allergie alimentaire de la Société française d’allergologie
This article is a non-systematic review on the epidemiology and burden of peanut allergy. Peanut allergy is one of the most common IgE-mediated food allergies in children, with an estimated prevalence in France of 0.9% at the age of 5.5 years based on questionnaires from the ELFE cohort. Peanut allergy begins in 90% of cases before the age of 3 years and spontaneously regresses in only 20 to 25% of cases before adulthood. Peanut allergy is associated with sensitization to one or more other legumes in two thirds of cases, and sometimes with a cross-allergy. Patients with peanut allergy most often have associated atopic comorbidities, particularly asthma. Peanut is one of the most common allergens involved in severe and even fatal food anaphylaxis and is associated with a high risk of allergy recurrence. Peanut allergy leads to impaired quality of life and has a significant psychosocial impact. Peanut-allergic patients probably have a different phenotype than patients with other food allergies. Multidisciplinary care and a personalized treatment strategy should be considered in these patients.
本文是一篇关于花生过敏的流行病学和负担的非系统综述。花生过敏是儿童中最常见的ige介导的食物过敏之一,根据ELFE队列的问卷调查,估计法国5.5岁儿童的患病率为0.9%。90%的花生过敏病例在3岁前开始,只有20%至25%的病例在成年前自行消退。在三分之二的病例中,花生过敏与对一种或多种其他豆类的过敏有关,有时还伴有交叉过敏。花生过敏患者通常伴有特应性合并症,尤其是哮喘。花生是最常见的过敏原之一,涉及严重甚至致命的食物过敏反应,并与过敏复发的高风险有关。花生过敏导致生活质量受损,并具有显著的社会心理影响。花生过敏的患者可能与其他食物过敏的患者有不同的表型。这些患者应考虑多学科护理和个性化治疗策略。
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引用次数: 0
De l’application de teinture capillaire à l’unité de soins intensifs : une réaction sévère à la para-phénylènediamine 从染发到重症监护室:对对苯二胺的严重反应
IF 0.3 4区 医学 Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1016/j.reval.2025.104584
F.Z. El Fatoiki, Z. Mouhsine, Y. Mahdar, F. Hali, S. Chiheb
Para-phenylenediamine (PPD), a common allergen in hair dyes and black henna tattoos, is typically responsible for allergic contact dermatitis and, rarely, systemic reactions like anaphylaxis. We report the case of a 22-year-old female with no significant medical history who developed pruritic eyelid edema and respiratory distress 24 hours after using a PPD-containing hair dye. She had prior exposure to black henna without issues. Clinical examination revealed erythematous plaques with vesicles and eyelid edema. Respiratory symptoms included dyspnea, tachycardia, and dysphonia. The patient required intensive care, receiving nebulized and intramuscular adrenaline, followed by corticosteroids. Patch testing confirmed a positive reaction to PPD. This case highlights the rare but possible coexistence of immediate and delayed hypersensitivity reactions to PPD, reflecting a complex and potentially severe immunologic mechanism. It emphasizes the importance of PPD regulation, patch testing for diagnosis, and prevention of repeated exposures.
对苯二胺(PPD)是染发剂和黑色指甲花纹身中常见的过敏原,通常会导致过敏性接触性皮炎,很少会引起过敏反应等全身性反应。我们报告一例22岁女性无明显病史,在使用含ppd的染发剂24小时后出现瘙痒性眼睑水肿和呼吸窘迫。她之前接触过黑色指甲花,没有问题。临床检查发现红斑斑块伴小泡及眼睑水肿。呼吸系统症状包括呼吸困难、心动过速和发音困难。患者需要重症监护,接受雾化和肌肉注射肾上腺素,随后使用皮质类固醇。斑贴试验证实对PPD有阳性反应。本病例强调PPD的即时和延迟超敏反应罕见但可能共存,反映了复杂且潜在严重的免疫机制。它强调了PPD调控、斑贴检测诊断和预防重复暴露的重要性。
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引用次数: 0
Chloroquine-induced erythema multiforme-like rash in a rheumatoid arthritis patient: A clinicalpresentation and management 类风湿关节炎患者氯喹引起的多形红斑样皮疹:临床表现和处理
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-03-20 DOI: 10.1016/j.reval.2025.104257
A.N. Jha , V.R. Gaikwad

Background

Chloroquine (CQ), a synthetic 4-aminoquinoline, has been widely used since its introduction in 1947 for the prevention and treatment of Plasmodium falciparum malaria. Its mechanism of action involves disrupting the parasite's ability to detoxify heme. Beyond its antimalarial role, chloroquine is frequently prescribed for autoimmune disorders such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) due to its immunomodulatory effects. Despite its inclusion in the WHO's List of Essential Medicines for its affordability and efficacy, chloroquine is associated with adverse effects, including gastrointestinal disturbances, headaches, skin rashes, cardiotoxicity, retinal damage, and hepatotoxicity. Long-term use may also result in neuromuscular, neuropsychiatric, and renal complications, requiring careful monitoring, particularly in vulnerable populations.

Case

A 48-year-old male, diagnosed with rheumatoid arthritis based on clinical and laboratory findings, was started on chloroquine 250 mg daily, folic acid 5 mg weekly, and paracetamol for symptom relief. After 15 days of therapy, the patient developed a progressive erythematous rash with maculopapular and targetoid lesions primarily affecting the hands, forearms, and trunk. A skin biopsy revealed histopathological features indicative of a drug-induced hypersensitivity reaction, including spongiosis, epidermal necrosis, and perivascular lymphocytic infiltration with eosinophils. Following the confirmation of a chloroquine-induced hypersensitivity reaction, the drug was discontinued, and the patient was treated with prednisolone 20 mg daily and omeprazole 20 mg twice daily. The rash resolved within days of initiating treatment.

Conclusion

This case highlights a rare but significant dermatological adverse effect of chloroquine, manifesting as an erythema multiforme-like hypersensitivity reaction. Early recognition and prompt discontinuation of the offending agent, coupled with appropriate symptomatic management, are critical to patient recovery. Clinicians must remain vigilant for such adverse reactions, particularly in patients prescribed chloroquine for autoimmune conditions like RA.
氯喹(chloroquine, CQ)是一种合成的4-氨基喹啉,自1947年问世以来被广泛用于预防和治疗恶性疟原虫疟疾。它的作用机制包括破坏寄生虫对血红素的解毒能力。除了抗疟疾作用外,由于其免疫调节作用,氯喹经常被用于治疗自身免疫性疾病,如类风湿关节炎(RA)和系统性红斑狼疮(SLE)。尽管氯喹因其可负担性和有效性被列入世卫组织基本药物清单,但它与不良反应有关,包括胃肠道紊乱、头痛、皮疹、心脏毒性、视网膜损伤和肝毒性。长期使用也可能导致神经肌肉、神经精神和肾脏并发症,需要仔细监测,特别是在脆弱人群中。病例a: 48岁男性,根据临床和实验室结果诊断为类风湿关节炎,开始服用每日250毫克氯喹,每周5毫克叶酸和扑热息痛以缓解症状。治疗15天后,患者出现进行性红斑疹,伴黄斑丘疹和靶样病变,主要累及手部、前臂和躯干。皮肤活检显示组织病理学特征表明药物引起的超敏反应,包括海绵状病、表皮坏死和血管周围淋巴细胞浸润伴嗜酸性粒细胞。在确认氯喹引起的超敏反应后,停用该药,并给予强的松龙20mg /天和奥美拉唑20mg /天两次治疗。皮疹在开始治疗后几天内消失。结论本病例突出了氯喹罕见但明显的皮肤不良反应,表现为红斑样多形超敏反应。早期识别和及时停用违规药物,加上适当的症状管理,对患者康复至关重要。临床医生必须对这类不良反应保持警惕,特别是对那些因自身免疫性疾病(如类风湿性关节炎)而服用氯喹的患者。
{"title":"Chloroquine-induced erythema multiforme-like rash in a rheumatoid arthritis patient: A clinicalpresentation and management","authors":"A.N. Jha ,&nbsp;V.R. Gaikwad","doi":"10.1016/j.reval.2025.104257","DOIUrl":"10.1016/j.reval.2025.104257","url":null,"abstract":"<div><h3>Background</h3><div>Chloroquine (CQ), a synthetic 4-aminoquinoline, has been widely used since its introduction in 1947 for the prevention and treatment of <em>Plasmodium falciparum</em> malaria. Its mechanism of action involves disrupting the parasite's ability to detoxify heme. Beyond its antimalarial role, chloroquine is frequently prescribed for autoimmune disorders such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) due to its immunomodulatory effects. Despite its inclusion in the WHO's List of Essential Medicines for its affordability and efficacy, chloroquine is associated with adverse effects, including gastrointestinal disturbances, headaches, skin rashes, cardiotoxicity, retinal damage, and hepatotoxicity. Long-term use may also result in neuromuscular, neuropsychiatric, and renal complications, requiring careful monitoring, particularly in vulnerable populations.</div></div><div><h3>Case</h3><div>A 48-year-old male, diagnosed with rheumatoid arthritis based on clinical and laboratory findings, was started on chloroquine 250<!--> <!-->mg daily, folic acid 5<!--> <!-->mg weekly, and paracetamol for symptom relief. After 15 days of therapy, the patient developed a progressive erythematous rash with maculopapular and targetoid lesions primarily affecting the hands, forearms, and trunk. A skin biopsy revealed histopathological features indicative of a drug-induced hypersensitivity reaction, including spongiosis, epidermal necrosis, and perivascular lymphocytic infiltration with eosinophils. Following the confirmation of a chloroquine-induced hypersensitivity reaction, the drug was discontinued, and the patient was treated with prednisolone 20<!--> <!-->mg daily and omeprazole 20<!--> <!-->mg twice daily. The rash resolved within days of initiating treatment.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare but significant dermatological adverse effect of chloroquine, manifesting as an erythema multiforme-like hypersensitivity reaction. Early recognition and prompt discontinuation of the offending agent, coupled with appropriate symptomatic management, are critical to patient recovery. Clinicians must remain vigilant for such adverse reactions, particularly in patients prescribed chloroquine for autoimmune conditions like RA.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104257"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of neutrophil-lymphocyte, platelet-lymphocyte ratio changes in patients with acute and chronic urticaria 急性和慢性荨麻疹患者中性粒细胞-淋巴细胞、血小板-淋巴细胞比值变化的评价
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-04-01 DOI: 10.1016/j.reval.2025.104552
S. Çevik , U. Altaş , H. Alkaya , A. Sarısaltık , M.Y. Özkars

Study objective

This study aimed to evaluate the changes in inflammatory markers, specifically neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in pediatric patients with acute and chronic urticaria. The objective was to compare these inflammatory indices between patients with acute urticaria, chronic urticaria, and healthy controls to determine whether they can be used as potential biomarkers for the evaluation of urticaria.

Patients and methods

The study included 200 participants: 100 with acute urticaria, 50 with chronic urticaria, and 50 healthy controls, all aged 0–18 years. Blood samples were taken to calculate NLR, PLR, systemic immune-inflammation index (SII), and other related indices. Specific allergen sensitivities were also evaluated using specific IgE tests and skin prick tests.

Results

The study found significant differences in NLR, PLR, and SII between the acute and chronic urticaria groups and the control group. NLR and PLR were significantly higher in the chronic urticaria group, suggesting ongoing inflammation. No significant difference was found in monocyte, platelet, eosinophil, and basophil counts.

Conclusion

The findings suggest that NLR, PLR, and SII could be potential biomarkers for assessing the inflammatory response in urticaria, particularly in differentiating between acute and chronic forms. However, further research is needed to confirm the clinical utility of these markers for routine evaluation in urticaria patients.
本研究旨在评价急性和慢性荨麻疹患儿炎症标志物,特别是中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)的变化。目的是比较急性荨麻疹患者、慢性荨麻疹患者和健康对照者之间的这些炎症指标,以确定它们是否可以用作评估荨麻疹的潜在生物标志物。患者和方法该研究包括200名参与者:100名急性荨麻疹患者,50名慢性荨麻疹患者和50名健康对照,年龄均为0-18岁。取血计算NLR、PLR、全身免疫炎症指数(SII)等相关指标。特异性过敏原敏感性也通过特异性IgE试验和皮肤点刺试验进行评估。结果急性、慢性荨麻疹组NLR、PLR、SII与对照组比较差异有统计学意义。慢性荨麻疹组NLR和PLR显著升高,提示持续炎症。单核细胞、血小板、嗜酸性粒细胞和嗜碱性粒细胞计数无显著差异。研究结果表明NLR、PLR和SII可能是评估荨麻疹炎症反应的潜在生物标志物,特别是在区分急性和慢性形式方面。然而,需要进一步的研究来证实这些标志物在荨麻疹患者常规评估中的临床应用。
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引用次数: 0
Pharmaciens et auto-injecteurs d’adrénaline : évaluation et optimisation des pratiques 药剂师和肾上腺素自动注射器:评估和优化实践
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-03-20 DOI: 10.1016/j.reval.2025.104540
S. Jégu , C. Rochefort-Morel , B. Le Daré , M. Mercerolle , G. Pouessel , E. Renard

Aim of the study

Adrenaline auto-injectors (AAIs) are the first-line emergency treatment for anaphylactic reactions in community practice. Community pharmacists play a crucial role in ensuring the proper use of these treatments by patients. The aim of this study is to evaluate the information provided to patients during the dispensing of AAIs in pharmacies.

Patients and methods

An 18-item questionnaire created on Google Forms® was sent to 956 pharmacies in Brittany (France) electronically via the Regional Council of Pharmacists from 26/10/23 to 30/11/23, including a reminder.

Results

A total of 105 (11%) pharmacists responded to the questionnaire, and 33 (31.4%) reported knowing how to use all four AAIs available in France. Only 11 (10.5%) pharmacists mentioned all the symptoms that justify the administration of an AAI, and 27 (26%) reported systematically providing explanations when dispensing. When information is provided, 96 (91%) pharmacists specify that the injection should be administered in the anterolateral thigh, and 43 (41%) mention the recommended injection duration. Storage instructions at room temperature are explained to patients by 90 (86%) pharmacists. Finally, 66 (63%) pharmacists reported difficulties in obtaining AAI supplies.

Conclusion

The quality of information provided by community pharmacists during the dispensing of AAIs could be optimized. Hands-on device workshops and simulations are potential areas for improvement in pharmacists’ initial and/or continuing education.
研究目的肾上腺素自动注射器(AAIs)是社区实践中治疗过敏反应的一线急救手段。社区药剂师在确保患者正确使用这些治疗方面发挥着至关重要的作用。本研究的目的是评估药房在分配AAIs时提供给患者的信息。患者和方法于23年10月26日至23年11月30日,通过地区药剂师委员会将一份在谷歌Forms®上制作的18项问卷以电子方式发送给布列塔尼(法国)的956家药店,其中包括提醒。结果共有105名(11%)药师参与问卷调查,其中33名(31.4%)药师了解如何使用法国现有的所有4种AAIs。只有11名(10.5%)药剂师提到了所有证明使用AAI合理的症状,27名(26%)药剂师报告在配药时系统地提供了解释。在提供信息时,96名(91%)药剂师明确指出应在大腿前外侧注射,43名(41%)药剂师提到推荐的注射时间。90名(86%)药剂师向患者解释室温下的储存说明。最后,66名(63%)药剂师报告难以获得AAI供应。结论可优化社区药师在AAIs调剂过程中提供的信息质量。动手设备研讨会和模拟是药剂师初始和/或继续教育的潜在改进领域。
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引用次数: 0
DRESS : panorama sur ses aspects phénotypiques et étiologiques à propos de 32 cas DRESS: 32例表型和病因概况
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-03-19 DOI: 10.1016/j.reval.2024.104225
S. Diadié, D.E.T. Ngbwa, M. Sarr, P.M. Mbengue, M. Diallo, S.O. Niang
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引用次数: 0
Allopurinol-induced Dress syndrome complicated with pancreatitis and ascites: Always look beyond the skin 别嘌呤醇诱导的Dress综合征并发胰腺炎和腹水:总是把目光放在皮肤之外
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-03-20 DOI: 10.1016/j.reval.2025.104254
M. Khallouki, L. Bendaoud, F. Zeroual, M. Aboudourib, O. Hocar, S. Amal
A 54-year-old male patient with a history of hypertension for the past two years was admitted to the dermatology department with pruriginous maculopapular skin rash, facial edema, and fever after the initiation of allopurinol for hyperuricemia six weeks previously. Dermatological examination revealed generalized erythema with scales, facial edema, cheilitis, and lymphadenomegaly. Laboratory tests showed eosinophilia at 2850/mm3, increased liver enzymes (alanine aminotransferase at 821 UI/L, aspartate aminotransferase at 258 UI/L, alkaline phosphatase at 278 UI/L), functional renal failure with creatinine at 74.59 mg/dL, and increased pancreatic lipase enzyme at 508 U/L. Abdominal sonography revealed normal renal size and a low-abundance ascites. The diagnosis of Dress syndrome was confirmed based on the diagnostic criteria of the RegiSCAR group. The incriminating drug was interrupted, and the patient received topical treatment, oral corticosteroids at a dose of 1 mg/kg/day, and supportive care, including rehydration. Clinical and biological remission was achieved. DRESS syndrome is a serious adverse drug reaction. Hepatitis is one of the most frequent visceral manifestations, while pancreatitis occurs in < 5% of cases. Allopurinol-induced DRESS syndrome is associated with significant mortality due to systemic manifestations. Judicious use of allopurinol for accepted indications is the only way to decrease the incidence and morbidity caused by allopurinol-induced Dress syndrome.
患者男,54岁,既往高血压病史2年,6周前因高尿酸血症开始使用别嘌呤醇治疗后出现瘙痒性斑疹丘疹、面部水肿及发热入住皮肤科。皮肤检查显示全身红斑伴鳞片,面部水肿,唇炎和淋巴肿大。实验室检查显示嗜酸性粒细胞增多2850/mm3,肝酶升高(丙氨酸转氨酶821 UI/L,天冬氨酸转氨酶258 UI/L,碱性磷酸酶278 UI/L),肾功能衰竭伴肌酐74.59 mg/dL,胰脂肪酶508 U/L升高。腹部超音波显示肾脏大小正常及低丰度腹水。根据RegiSCAR组的诊断标准确定Dress综合征的诊断。中断犯罪药物治疗,患者接受局部治疗、口服皮质类固醇(剂量为1mg /kg/天)和支持性护理,包括补液。达到临床和生物学缓解。DRESS综合征是一种严重的药物不良反应。肝炎是最常见的内脏表现之一,而胰腺炎发生在胰腺炎。5%的病例。别嘌呤醇诱导的DRESS综合征与系统性表现引起的显著死亡率相关。在公认的适应症中合理使用别嘌呤醇是减少别嘌呤醇所致Dress综合征发生率和发病率的唯一途径。
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引用次数: 0
Dermite de contact à l’huile de cade 菜籽油接触皮疹
IF 0.3 4区 医学 Pub Date : 2025-07-01 Epub Date: 2025-03-31 DOI: 10.1016/j.reval.2025.104553
K. Kaddar , N. Tahri , O. Hormi , N. Zizi , S. Dikhaye
Cade oil has long been used in herbal medicine for its antifungal and antiseptic properties. These properties make it an oil of choice for scaly scalp conditions. We report the case of a 32-year-old woman who presented with contact dermatitis few hours after application of cade oil as a hair mask treatment. A patch test performed revealed a strong positive reaction to cade oil after 48 hours. The patient was treated with topical corticosteroids, showing significant improvement after 3 days.
卡德油具有抗真菌和杀菌的特性,长期以来一直被用于草药中。这些特性使其成为治疗头皮鳞屑病症的首选用油。我们报告了一例 32 岁女性的病例,她在使用卡德油作为发膜治疗数小时后出现了接触性皮炎。48 小时后进行的斑贴试验显示,患者对卡德油产生了强烈的阳性反应。患者接受了局部皮质类固醇治疗,3 天后病情明显好转。
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Revue Francaise d Allergologie
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