- 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=1739015646-dWaj1URC2yXOBsCdF0Vfa4mhkMcqRfdr-0-c045ff111b3a35612bd85f083c248f94)
图9-1-1 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-2_13820.jpg?sign=1739015646-r0Uq7NA99oZFYcgw1YYvXRtzBmdLAZFB-0-f9bed48bbd3055ba15d10d79d5aa66ce)
图9-1-2 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-3_13821.jpg?sign=1739015646-a7QnxwVV3MLHxqD5PSvNMsrDM6aBF5cv-0-fbb81acb3e0175df89ff73ad666cc5e2)
图9-1-3 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-4_13822.jpg?sign=1739015646-GDwWKnfXSPBqw96O2LC2EUduBBLruU8d-0-42b28e7bdc0e02d8789276c7d989b289)
图9-1-4 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-5_13823.jpg?sign=1739015646-HfKDJec3iPio82QrZFFmgIydEoRIt8I5-0-7dae268b15e0222e52b6cdd305bce8a8)
图9-1-5 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-6_13824.jpg?sign=1739015646-FjAkjsYrVBbOXs8S61VVyQYClafkRj2X-0-af2d07d9c6d9db1e7ae52744f05b5e6a)
图9-1-6 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-7_13825.jpg?sign=1739015646-3WrO0VG49Wu4nr7rIBthbYeAMNoagdIE-0-f9e1a44e6be5d1104f116e166bc8cea9)
图9-1-7 多形红斑
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P9-1-8_13826.jpg?sign=1739015646-0p0QgTUxhrurCg2G2CyIfThpeBNm4c3x-0-f66e95c962e6876d77de2c66d3a3fe05)
图9-1-8 多形红斑