中国麻风皮肤病杂志 ›› 2023, Vol. 39 ›› Issue (5): 382-386.doi: 10.12144/zgmfskin202305382

• 综述 • 上一篇    下一篇

中毒性表皮坏死松解症病因及发病危险因素研究进展

高澜1,劳力民2   

  1. 1浙江大学医学院公共卫生系，杭州，310011；2浙江大学医学院附属第二医院皮肤科，杭州，310009
  • 出版日期:2023-05-15 发布日期:2023-05-17

Update of etiology and risk factors of toxic epidermal necrolysis

GAO Lan1, LAO Limin2   

  1. 1 Department of Public Health, School of Medicine, Zhejiang University, Hangzhou 310011, China;2 The Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China
  • Online:2023-05-15 Published:2023-05-17

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摘要： 中毒性表皮坏死松解症是可危及生命的皮肤黏膜反应。药物是其主要的致病原因，药物基因组学揭示HLA基因与芳香族类抗癫痫药、非甾体类抗炎药等引起SJS/TEN具有密切联系，细胞色素P450变异可致药物代谢缓慢并增加SJS/TEN风险。免疫检查点抑制剂可导致包括SJS/TEN在内的皮肤免疫相关不良反应。人类疱疹病毒、EB病毒、肺炎支原体等感染因素与SJS/TEN的发展有关。自身免疫性疾病、活动性恶性肿瘤等其他因素也是SJS/TEN的潜在危险因素。本文就TEN的病因及危险因素的研究进展进行综述。

关键词: 中毒性表皮坏死松解症, 病因, 危险因素

Abstract: Toxic epidermal necrolysis(TEN) is a skin-mucosal reaction that can be life-threatening. Drugs are the main cause of SJS/TEN. Pharmacogenomics reveals that HLA genes are closely related to SJS/TEN caused by aromatic anticonvulsants and non-steroidal anti-inflammatory drugs(NSAIDs). Cytochrome P450(CYP450）variants can cause slow drug metabolism and increase the risk of SJS/TEN. Immune checkpoint inhibitors can cause skin immune-related adverse effects, including SJS/TEN. Human herpes virus, Epstein-Barr virus, Mycoplasma pneumoniae and other infectious factors are related to the development of SJS/TEN. Other factors such as autoimmune diseases and active cancer are also potential risk factors for SJS/TEN. The update of etiology and risk factors of toxic epidermal necrolysis was reviewed in this paper.

Key words: toxic epidermal necrolysis, etiology, risk factors