药物超敏反应综合征20例临床及组织病理分析  

Clinical and Histopathological Analysis of 20 Durg Induced Hypersensitivity Syndrome

作　　者：车启蕾 付萌[1] 刘宇[1] 王刚[1] 廖文俊[1] 马翠玲[1] 樊平申[1] 李承新[1] 

机构地区：[1]第四军医大学西京皮肤医院,陕西西安710032

出　　处：《中国皮肤性病学杂志》2016年第7期695-698,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的了解药物超敏反应综合征(drug induced hypersensitivity syndrome,DIHS)患者皮损的组织病理特征,区分其与发疹型药疹(exanthematous reactions,ER)患者皮损的组织病理特征。方法采用RegiSCAR评分系统,对2006-2014年在西京皮肤医院住院的DIHS病例进行评分,对评为确诊/很可能的DIHS病例皮损组织病理资料进行分析,并与11例ER病例皮损组织病理资料作比较。结果 RegiSCAR评分显示,20例诊断为确诊/很可能的DIHS。20例患者均有不同程度地发热、淋巴结肿大、血液学改变、脏器累及。20例患者皮疹表现各异。DIHS和ER病例皮损均见角质形成细胞坏死、淋巴细胞外渗、表面海绵水肿、界面空泡变性、真皮淋巴细胞及嗜酸性粒细胞浸润等主要特征。与ER相比,DIHS病例皮损以上改变显著多于ER病例皮损以上改变。结论 DIHS病例较ER病例有更显著的角质形成细胞坏死、表皮海绵水肿、淋巴细胞外渗、界面空泡变性及真皮不典型淋巴细胞浸润。Objective To understand the lesion skin histopathological features of DIHS, and to find the difference between DIHS and ER. Method We assessed the cases that discharge diagnosis for DIHS in the department of dermatology. Xijing Hospital between 2006 and 2014 by the RegiSCAR scoring system, and analyzed lesion skin histopathological features of probable/definite DIHS, also made comparisons with 11 ER. Results 20 cases were probable/definite DIHS defined by the RegiSCAR scoring system. Twenty patients had fever, lymph node enlargement, hematological changes, organ involvement in different extent. Twenty patients had various cutaneous manifestations. Apoptotic keratinocytes, lymphocytic extravasation, epidermal spongiosis, interface vacuolization, dermal lymphocytes and eosinophilic infiltration were seen both DIHS and ER. Coompared with ER, these changes were more prominent in DIHS than ER. Conclusion There are more prominent histopathologic features of apoptotic keratinocytes, lymphocytic extravasation, epidermal spongiosis, interface vacuolization, dermal atypical lymphocytes infiltration in DIHS than ER.

关 键 词：药物超敏反应综合征 发疹型药疹 组织病理 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]