史帝文生強生症候群－病例報告

Stevens-Johnson Syndrome-A Case Report

戎家恆(Chia-Hen Rong) ； 邱國洲(Kuo-Chuo Chiu)

《中華民國家庭牙醫學雜誌》 5卷1期 (2010/06) Pp. 50-56

https://doi.org/10.6566/JFD/2010.5(1).50

摘要

史帝文生強生症候群(Stevens-Johnson syndrome)是一種少見但卻可能致命的黏膜皮膚疾病。近來，史帝文生強生症候群和另一更為致命，稱為毒性表皮壞死分解症(toxic epidermal necrolysis)的疾病被認為是屬於為同一類的疾病，且分別造成5%以下及30到50%的死亡率。兩者皆造成黏膜和皮膚的傷害，黏膜病變主要在口腔、眼球和外陰部，會造成黏膜麋爛潰瘍。皮膚病變症狀從輕微的標靶狀紅斑到嚴重的大範轉皮膚脫落。兩者被認為是一種過敏反應，藥物是引起此疾病的主要因素，目前有超過一百種藥物被發現與發病有關，特別是磺胺類(sulfonamides)、抗痙攣藥(anticonvulsants)、非類固醇類止痛抗發炎藥物NSAIDs及降尿酸藥物等。造成史帝文生強生症候群的病因有一半被認為和藥物有關，其他因素則包括感染、惡性腫瘤、環境毒素及自體免疫疾病。本文報告一個少見非藥物引起的史帝文生強生症候群的案例，並探討此疾病的臨床特性及治療方式。

關鍵字

史帝文生強生症候群

並列摘要

Stevens-Johnson syndrome is a rare but potentially life-threatening mucocutaneous disease. It has been suggested that Stevens-Johnson syndrome and Toxic epidermal necrosis, a more fatal disorder, belong to the same pedigree of mucocutaneous disorders. The mortality rates are up to 5% and 30-50% respectively. These two diseases both cause the damage of mucosa and skin. Mucosal erosions over oral cavity, eyeballs, and external genital organs are the main predilection sites. Characteristically, skin damage shows mild target-like macules to severe extensive epidermal sloughing. These diseases are regarded as hypersensitive reactions which are predominantly drug-induced. More than 50% etiologies of Stevens-Johnson syndrome patients are drug-induced. More than 100 varieties of drugs have been implicated to be associated with this syndrome. Sulfonamides, anticonvulsants, NSAIDs and the uricosuric agents are the most common three drugs. Other etiologies include infections, malignant tumors, environmental toxins and autoimnuine disorders. Here we report a case of a rare non-drug induced Stevens-Johnson syndrome with its clinical appearances and its treatment protocols.

並列關鍵字

Stevens-Johnson syndrome