多發性移行性紅斑以Minocycline治療伴隨Jarisch-Herxheimer Reaction－病例報告暨文獻回顧－

Multiple Erythema Migrans Treated with Minocycline Accompanied with Jarisch-Herxheimer Reaction

童麗娜(Li-Na Tung) ； 蘇信義(Hsin-Yi Su) ； 師健民(Chien-Ming Shih) ； 趙麗蓮(Li-Lian Chao) ； 陳秀琴(Hsiu-Chin Chen)

《中華皮膚科醫學雜誌》 20卷2期 (2002/06) Pp. 152-160

摘要

我們報告一位29歲男性出現多發性移行性紅斑，其臉部病灶以嚴重紅腫伴隨著水泡、滲出液、結痂及脫屑等不尋常病癥變化為表現。依據病患之旅遊史、臨床表現及血清學檢驗結果診斷為萊姆病。在給與minocycline治療之後，病患出現頭痛、疲倦、頸部及腰部酸痛、原有皮膚病灶加重及出現新的移行性紅斑病灶等病癥。給與口服類固醇後發現症狀消退。此一急性反應可能是由於給與minocycline之後發生了Jarish-Herxheimer reaction。此病例為目前台灣地區關於水泡型移行性紅斑及其治療過程中所發生的Jarisch-HerxheimerReaction之第一次正式報告。

並列摘要

We herein present a 29-year-old male who had ultiple lesions of erythema migrans. An nusual
presentation of severe erythematous swelling of face with vesicular, exudative, crusted, and scaling
change over it was noted . Lyme disease was diagnosed according to the travel history., clinical
manifestations, and serological findings. Following treatment with minocycline, he developed headache,
malaise, soreness of neck and waist, and exacerbation of the skin lesions accompanied with some new
lesions. The symptoms subsided after oral steroid was prescribed. This exacerbation was considered to be
caused by Jarisch-Herxheimer reaction. This is the first reported case of Lyme disease with vesicular
erythema migrans and Jarisch-Herxheimer eaction in Taiwan.

並列關鍵字

erythema migrans ； vesicular ； Lyme disease ； Minocycline ； Jarisch-Herxheimer reaction