摘要
1例90岁男性患者因高血压病、血管性痴呆口服苯磺酸氨氯地平、盐酸多奈哌齐、奥氮平,后加用托吡酯25 mg,2次/d控制易激惹等精神行为异常。托吡酯治疗后第22天,患者出现全身皮肤轻度发红,予甲泼尼龙20 mg,1次/d静脉滴注。13 d后出现全身弥漫性红斑伴瘙痒、部分红斑融合。5 d后进展为大片皮肤表皮脱落。诊断为剥脱性皮炎。停用托吡酯,甲泼尼龙剂量加倍并外用氧化锌洗剂,同时给予抗炎、补充白蛋白等对症支持处理。12 d后,皮疹消退。
A 90-year-old male patient with hypertension and vascular dementia was treated with amlodipine besilate, donepezil hydroehloride and olanzapine. Oral topiramate 25 mg twice daily was added to his regimen due to irritability and other abnormal mental status and behaviors. On day 22 of treatment with topiramate, he developed generalized flushing. An infusion of methylprednisolone 20 mg once daily was given. After 13 days, diffuse erythema involving his entire body with pruritus and partial plaques fusion developed. His symptoms progressed to large areas of skin exfoliation after 5 days. Exfoliative dermatitis was diagnosed. Topiramate was stopped and he was treated with methylprednisolone double dosage and topical zinc oxide lotion. At the same time, he received symptomatic treatment and supportive therapy such as antiinflammatory and albumin supplement. Twelve days later, patient＇s rash subsided.
出处
《药物不良反应杂志》
CSCD
2014年第1期42-43,共2页
Adverse Drug Reactions Journal
关键词
托吡酯
皮炎
剥脱性
Topiramate
Dermatitis, exfoliative
