外用斑蝥粉中毒引起大疱性表皮松解症致死亡  

Death due to epidermolysis bullosa induced by topical application of blister beetle(Mylabris)powder

作　　者：刘引引[1] 李凡[1] 范兆普[1] 霍亚兰[1] Liu Yinyin;Li Fan;Fan Zhaopu;Huo Yalan(Department of Dermatology,Karamay Central Hospital of Xinjiang,Xinjiang Uygur Autonomous Region,Karamay 834000,China)

机构地区：[1]新疆克拉玛依市中心医院皮肤科,834000

出　　处：《药物不良反应杂志》2020年第7期424-425,共2页Adverse Drug Reactions Journal

摘　　要：1例50岁男性患者因银屑病自行购买斑蝥虫体研粉调成糊状全身大面积外用。数分钟后,患者用药部位出现红斑和水疱;数小时后紫红色斑片和水疱弥漫至全身,表皮松弛、剥脱,并出现全身中毒症状。1 d后患者出现呼吸衰竭、肝损伤、肾损伤、严重低蛋白血症、凝血功能异常等多器官衰竭。诊断为外用斑蝥致大疱性表皮松解症,给予大剂量甲泼尼龙冲击治疗,静脉滴注人免疫球蛋白,补充人血白蛋白、床旁血液滤过、呼吸机辅助通气等治疗。但患者病情迅速加重,12 h后因多器官衰竭而死亡。A 50-year-old male patient grinded his self-purchased blister beetle(Mylabris)body into powder and then made it into paste for large area external use on his body skin for psoriasis.A few minutes later,the patient developed erythema and blisters on the site of medication;a few hours later,the purplish-red patches and blisters spread throughout the body,epidermis relaxed and exfoliated,and symptoms of systemic poisoning appeared.One day later,the patient developed multiple organ failure,such as respiratory failure,liver injury,kidney injury,severe hypoproteinemia,and abnormal coagulation function.Epidermolysis bullosa induced by externally application of Mylabris was diagnosed,and treatments of high-doses of pulsetherapy methylprednisolone,intravenous infusions of human immunoglobulin and human albumin,bedside hemofiltration,ventilator-assisted ventilation,and etc.were given.However,the patient′s condition deteriorated rapidly and finally he died of multiple organ failure 12 hours later.

关 键 词：斑蝥素 银屑病 投药 皮肤 中毒 表皮松解 大疱性 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]