摘要
患者女,34岁,因癫痫应用丙戊酸钠联合拉莫三嗪治疗,出现面部、掌跖红斑伴口腔溃疡2个月。实验室检查:血红蛋白95 g/L,白细胞3.7×10^(9)/L,ANA 1∶1000斑点型,抗SSA(3+),抗SSB(3+),抗Ro-52(3+),Coombs试验阳性;基因检测示:HLA-B*15:02突变。面部皮损组织病理示:表皮可见痂皮,毛囊口扩张伴角化过度,局灶基底细胞液化变性,真皮浅层水肿,真皮浅层附属器及小血管周围见淋巴单核细胞浸润,真皮深层未见明显病变。结合患者病史、临床表现及实验室检查,诊断为拉莫三嗪所致的Rowell综合征。
A 34-year-old female patient with epilepsy was treated with valproate and lamotrigine.She developed facial and acral erythema with oral ulcers for 2 months.Laboratory findings showed hemoglobin was 95 g/L,white blood cell was 3.7×10^(9)/L,ANA was 1∶1000 speckled pattern,anti-SSA(3+),anti-SSB(3+),anti-Ro-52(3+),and positive Coombs test.Genetic testing revealed HLA-B*15:02 mutation.Histopathological examination of facial skin lesions showed crust overlying the epidermis,follicular dilatation with hyperkeratosis,focal liquefaction degeneration of basal cells,superficial edema in the dermis,and perifollicular and perivascular lymphocytic infiltration in the superficial dermis,with no obvious lesions in the deep dermis.Based on patient′s history,clinical manifestations and laboratory examination,the diagnosis of Rowell syndrome induced by lamotrigine was made.
作者
胡媛
唐佳
HU Yuan;TANG Jia(Department of Dermatology,Suining Central Hospital,Suining 629000,China)
出处
《中国皮肤性病学杂志》
北大核心
2025年第9期1044-1046,共3页
The Chinese Journal of Dermatovenereology
