烧伤病人患者治疗课件.pptVIP

contents Definition Etiology and pathogenesis Clinical feature Daignoses and Differential Diagnoses Management 一、Definition定义 drug eruption:Drug was gotten into human body by all kinds of ways, causing cutaneous、mucocutaneous inflammatory reactions. At times the conditions can be serious,with involvement of a number of systems,and can even become life-threatening. 药疹(drug eruption)又称药物性皮炎(dermatitis medicamentosa),是药物通过各种不同的途径（内服oral administration 、注射injection 、吸入inhalation 、灌注priming 、栓剂turunda [t?r?nd?]等）进入人体后，在皮肤黏膜上引起炎症反应，严重者可累及机体的其他系统。 由药物引起的非治疗性反应，统称为药物反应，药疹仅是其中的一种表现形式。 Frequency Drug eruptions occur in approximately 2-5% of inpatients and in greater than 1% of outpatients in American. In China ? etiology individual factor:机体对药物的敏感性各不相同，(genetic factors,enzyme deficencies)同一个体在不同的时期，敏感性也可不同。concurrent infections, metabolic disorders, or immunocompromise Drug 药物因素 Virus activating 病毒的活化 analgesics [?n?l‘d?i:ziks] antipyretics解热镇痛 sedative [sed?tiv] Hypnotics镇静安眠 anticonvulsants Type I is immunoglobulin E (IgE)–dependent reactions, which result in urticaria, angioedema Type II is cytotoxic reactions, which result in hemolysis and purpura.Oral ulcerations in a patient receiving cytotoxic therapy Type III is immune complex reactions, which result in vasculitis, serum sickness, and urticaria. Type IV is delayed-type reactions with cell-mediated hypersensitivity, which result in contact dermatitis, exanthematous reactions, and photoallergic reactions. Insulin and other proteins are associated with type I reactions. Penicillin, cephalosporins, sulfonamides, and rifampin are known to cause type II reactions. Quinine, salicylates, chlorpromazine, and sulfonamides can cause type III reactions. Type IV reactions, the most common mechanism of drug eruptions, are often encountered in cases of contact hypersensitivity to topical medications, such as neomycin. Sulfonamides are most frequently associated with toxic epidermal necrolysis (TEN). Type IV cell-mediate