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1、1Burn烧伤患者？2Whatarethesedisease????3药疹drugeruption昆明医学院皮肤性病学教研室付萍教授contentsDefinitionEtiologyandpathogenesisClinicalfeatureDaignosesandDifferentialDiagnosesManagement一、Definition定义drugeruption:Drugwasgottenintohumanbodybyallkindsofways,causingcutaneous、mucocutaneousinflammatoryr
2、eactions.Attimestheconditionscanbeserious,withinvolvementofanumberofsystems,andcanevenbecomelife-threatening.药疹(drugeruption)又称药物性皮炎(dermatitismedicamentosa),是药物通过各种不同的途径（内服oraladministration、注射injection、吸入inhalation、灌注priming、栓剂turunda['tʌrʌndə]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
3、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。FrequencyDrugeruptionsoccurinapproximately2-5%ofinpatientsandingreaterthan1%ofoutpatientsinAmerican.InChina?etiologyindividualfactor:机体对药物的敏感性各不相同，(geneticfactors,enzymedeficencies)同一个体在不同的时期，敏感性也可不同。concurrentinfections,metabolicdisorders,
4、orimmunocompromiseDrug药物因素Virusactivating病毒的活化9antibiotic解热镇痛药Analgesicsantipyretics镇静催眠sedative,hypnotics抗癫痫anticonvulsants血清制品Serumproduct其他中药chinesemedicineetiologyanalgesics[ænəl‘dʒi:ziks]antipyretics解热镇痛sedative[sedətiv]Hypnotics镇静安眠anticonvulsants11发病机制Thepathogenesisofdr
5、ugeruptionisisquitecomplicated,butcansimplebedividedintoImmunologicallymediatedreactionsand变态反应性Nonimmunologicallymediatedreactions非变态反应性,theformerbeingmorecommon发病机制pathogenesis12semiantigen（大多数药物）+载体（蛋白、多肽、多糖）血清制品、疫苗antigenallergy4typeallergy一、变态反应性mmunologicallymediatedreact
6、ions●具体某一种药物通过那一型变态反应引起药疹大多不清●一种药疹可能几种变态反应共同参与TypeIisimmunoglobulinE(IgE)–dependentreactions,whichresultinurticaria,angioedemaTypeIIiscytotoxicreactions,whichresultinhemolysisandpurpura.OralulcerationsinapatientreceivingcytotoxictherapyTypeIIIisimmunecomplexreactions,whichresul
7、tinvasculitis,serumsickness,andurticaria.TypeIVisdelayed-typereactionswithcell-mediatedhypersensitivity,whichresultincontactdermatitis,exanthematousreactions,andphotoallergicreactions.InsulinandotherproteinsareassociatedwithtypeIreactions.Penicillin,cephalosporins,sulfonamides,
8、andrifampinareknowntocausetypeIIreactions.Quinine,sali
