- 中国皮肤病性病图鉴(第3版)
- 朱学骏
- 23字
- 2021-12-13 16:20:42
第九章 红斑性皮肤病、药疹及荨麻疹
Erythematous Dermatoses,Drug Eruption and Urticaria
多形红斑 Erythema Multiforme
皮疹呈多形性,靶形皮疹具有特征性。病因与单纯疱疹病毒感染有关。重症多形红斑(Stevens-Johnson syndrome)可由药物过敏引起。
诊断要点:
多见于中青年。好发于肢端、手、足、口周、鼻及耳廓,严重者可泛发全身。常侵及皮肤黏膜交界处,如口唇。以春秋季多见,可以复发。患者有大小不等浮肿性红斑,中央有水疱、大疱、渗出。典型皮损为靶形(虹膜状)损害。重症多形红斑除皮损广泛严重外,常有眼结膜、口腔黏膜、外阴及消化道黏膜受累,出现大疱、糜烂等,患者有高热等全身症状,严重时可危及生命。
治疗要点:
本病多数在几周内自行消退,一般做对症处理。反复发作者,可针对单纯疹病毒感染,给予阿昔洛韦等抗病毒药物。重症多形红斑患者系统用糖皮质激素。对黏膜损害应加强对症治疗。
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-1_13819.jpg?sign=1739473284-d2Un5RpvzuOzB8dsFKwXx0OtihLhClNv-0-01bc253af7b0e7ffe627fc8ac063a769)
图9-1-1 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-2_13820.jpg?sign=1739473284-6B7nfT2W5P079vICZQnjsrfsRp1v0Dfv-0-dadad42aacab7889fed6990d579f1a7d)
图9-1-2 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-3_13821.jpg?sign=1739473284-LHoU10AAKkNCZ1fRmFez1iK7kC9uB31R-0-6ead11175cba60ee97a94381bb1859f6)
图9-1-3 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-4_13822.jpg?sign=1739473284-DdWUHhMY4Ami9h1VS8RqP6xsMg34D4iF-0-b505ca6db6d2c864d75a21e83efaa77b)
图9-1-4 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-5_13823.jpg?sign=1739473284-Re9jIiIIO8u5iOfhsTRvGPd64DKikapY-0-9d6ec9d97b6f0ca28bab535805cd0c91)
图9-1-5 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-6_13824.jpg?sign=1739473284-3WeSAX2Boc5CToFiwalKWAlAM3z8pp0M-0-cddaf6a6a83f48f25e00d02d9b00b24a)
图9-1-6 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-7_13825.jpg?sign=1739473284-XXPEKWGCT3Vdyk6hisDs6DrOLw40UXtS-0-216538cd38a833a44cb927ab1befe8e0)
图9-1-7 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-8_13826.jpg?sign=1739473284-UemPSaR3yGtHKraf8KqBxBOSIi4H5qnJ-0-c11520c5a675e4d128d544c73ae21235)
图9-1-8 多形红斑