Zeynoire Anderson, A. Fotouhi, S. Tolliver, Darius Mehregan
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引用次数: 0
摘要
最近,有人讨论将小儿史蒂文斯-约翰逊综合征/毒性表皮坏死症(SJS/TEN)重新归类为药物诱发表皮坏死症(DEN),将其与感染性病因分开,并将小儿粘膜糜烂重新定义为反应性感染性粘膜糜烂(RIME)或DEN。在本报告中,我们描述了一名原本健康的 4 岁女孩,在鼻病毒和肠道病毒感染前驱症状出现后,她的粘膜水疱迅速进展,累及四层粘膜,占体表总面积(BSA)的 37.5%。这些症状是在没有使用诱发药物的情况下出现的,并且仅通过支持性护理就得到了改善。该病例说明了一种罕见的 RIME,即 TEN 样 BSA 受累,这促使人们对文献进行回顾,探讨 RIME 中 BSA 受累之间的关系及其对患者预后的影响。研究结果支持将 SJS/TEN 重新分类为 DEN 和将感染后粘膜糜烂重新分类为 RIME 的建议。
Reactive Infectious Mucocutaneous Eruption with Extensive Cutaneous Involvement
Recently, there has been discussion to reclassify pediatric Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) as drug-induced epidermal necrolysis (DEN), separating it from infectious etiologies and redefining pediatric mucocutaneous eruptions as either reactive infectious mucocutaneous eruption (RIME) or DEN. In this report, we describe a previously healthy 4-year-old girl with rapidly progressive mucocutaneous blistering involving four mucosal membranes and 37.5% of total body surface area (BSA) following a prodromal rhinovirus and enterovirus infection. The symptoms occurred in the absence of an inciting medication and improved with only supportive care. This case illustrates a rare occurrence of RIME with TEN-like BSA involvement, prompting a review of the literature exploring the relationship between BSA involvement in RIME and its influence on patient outcomes. Findings support the proposed reclassification of SJS/TEN as DEN and postinfectious mucocutaneous eruptions as RIME.