珍菊降压片所致光敏性药疹的临床研究.pdfVIP

746 2 !至 12 第40卷第 l2期 Chin J Dermatol，December 2007，Vo1．40，No．12 · 论 著 · 珍菊降压片所致光敏性药疹的临床研究 周平玉 杨连娟 陆海空 顾志英 徐丽英 【摘要】 目的 了解珍菊降压片所致光敏性药疹的临床特点，以引起人们对该药所致药疹的重视。 方法 对38例服用珍菊降压片后发生皮疹患者的病史、皮损特点、光试验和治疗情况进行分析。结果 38例患者中服珍菊降压片时间最短为2周，最长为2年。皮损仅局限于暴光部位的36例，主要表现为水 肿性红斑，少数患者有丘疹、丘疱疹；皮损同时累及非暴光部位的有2例，皮损表现为红斑、丘疹、丘疱疹、 斑块、风团等多形性损害；16例患者在治疗前进行了光试验，其中有7例对中波紫外线敏感，3例对长波 紫外线和中波紫外线均敏感，另6例则为正常反应。所有患者在停用珍菊降压片后，口服烟酰胺和抗组 胺药，外用炉甘石洗剂或糖皮质激素乳膏。皮损于1～3周内基本消退，仅2例患者在2月后仍有皮损。 结论 珍菊降压片导致的光敏性药疹主要为光毒反应，表现为水肿性红斑，也可能存在光变态反应，皮损 表现为多形性，应引起临床医生的重视。 【关键词】药疹；噻嗪类；珍菊降压片 Clinical study of Zhenju Jiangya Pian—induced photosensitive drug eruptions ZHOU Ping-yu, Yang Lian-juan．LU Hai-kong,GU Zhi-ying,XU Li-ying．Shanghai SkinSTD Hospital,Shanghai 200050，China 【Abstract】Objective To investigate and highlight the clinical features of photosensitive drug erup— tions induced by Zhenju Jiangya Pian．Methods Thirty—eight cases of Zhenju Jiangya Pian—induced photo— sensitive drug eruptions were studied retrospectively．Medical records，clinical manifestations，phototest results and treatment strategies were assessed for these patients．Results The duration ofdrug exposure varied from 2 weeks to 2 years．The lesions in 36 patients were localized on sun exposed area，and mainly mani— fested as edematous erythematous plaques，and less frequently as papules and papulovesicles．In the remaining 2 cases，unexposed area was also involved，the skin lesions manifested as erythematous papules，papulovesi— cles and plaques．Phototesting was performed in 16 patients before treatment：7 had abnorm al response to UVB，3 to UVA and UVB，and phototest results were norm al in 6 patients．All patients discontinued the application of Zhenju Jiangya Pian，and were given oral nicotinamide and antihistamines as well as topical calamine lotion and corticosteroids cream．Conclusions The drug eruption induced b