中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (6): 436-439.doi: 10.12144/zgmfskin202506436

• 病例报告 • 上一篇    下一篇

糖皮质激素冲击治愈重症中毒性表皮坏死松解症一例

王娜1,2,刘静1,2,宋平平1,2,冉德琳1,2,杨宝琦1,2,刘红1,2,张福仁1,2   

  1. 1山东第一医科大学附属皮肤病医院，山东济南，250022； 2山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2025-06-15 发布日期:2025-05-23

Severe toxic epidermal necrolysis cured by corticosteroid pulse therapy: a case report

WANG Na1,2, LIU Jing1,2, SONG Pingping1,2, RAN Delin1,2, YANG Baoqi1,2, LIU Hong1,2, ZHANG Furen1,2   

  1. 1 Dermatology Hospital of Shandong First Medical University, Jinan 250022, China; 2 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2025-06-15 Published:2025-05-23

PDF (PC)

10

摘要： 患者，男，48岁。因接触喷漆诱发重症中毒性表皮坏死松解症（TEN）。该患者入院时表皮剥脱面积达35%，给予足量糖皮质激素、肿瘤坏死因子α抑制剂及大剂量免疫球蛋白治疗无效，病情加重，出现感染性休克、电解质紊乱、氧饱和度下降、高热等症状。入院第8天采用糖皮质激素冲击治疗，首日甲泼尼龙600 mg，之后分别为400 mg×4 d、200 mg×1 d治疗。入院第17天患者表皮完全再生，病情继续好转，糖皮质激素逐渐减量，皮肤黏膜恢复正常。住院22天患者痊愈出院，出院2周后停用糖皮质激素，随访2年未复发。

关键词: 中毒性表皮坏死松解症, 糖皮质激素, 冲击治疗

Abstract: A 48-year-old male presented with severe toxic epidermal necrolysis(TEN) induced by spray paint exposure. The patient was critically ill and had an exfoliated area of 35% at admission. Treatment with glucocorticoids, tumor necrosis factor α inhibitors and high-dose immunoglobulin failed, and the exfoliated area increased to 76%, with septic shock, electrolyte disorder, oxygen saturation drop, high fever. On the 8th day of admission, glucocorticoid shock therapy was administered, methylprednisolone 600 mg on the first day, followed by 400 mg for 4 days and 200 mg for 1 day. On the 17th day of admission, the epidermis of the patient was completely regenerated and the condition continued to improve, the glucocorticoid was gradually reduced, and the skin mucosa returned to normal. After 22 days of hospitalization, the patient recovered and was discharged from the hospital. After 2 weeks of discharge, the glucocorticoid was stopped and there was no recurrence during the follow-up of 2 years.

Key words: toxic epidermal necrolysis, glucocorticoid, pulse therapy