A 43-year-old man developed a skin eruption characterized by 'macules with blisters' typical to Stevens-Johnson syndrome, as well as erosions of the lips and buccal mucosa, 2 weeks after he had started treatment with lamotrigine. He had a fever (39.6 degrees C), elevated liver enzymes and atypical lymphocytes in the peripheral blood. This undoubtedly reflects a case of Stevens-Johnson syndrome induced by lamotrigine, but it can also fulfill the criteria of anticonvulsant hypersensitivity syndrome or drug rash with eosinophilia and systemic signs. A case that precisely fits the definition of two syndromes that have different characteristics, different treatments and different prognoses indicates that there is a flaw in the classification.

译文

一名43岁的男子在开始使用拉莫三嗪治疗2周后,出现了以史蒂文斯-约翰逊综合征典型的 “带水疱的斑疹” 以及嘴唇和颊粘膜糜烂为特征的皮肤喷发。发热 (39.6 ℃),肝酶升高,外周血淋巴细胞不典型。这无疑反映了拉莫三嗪诱发的史蒂文斯-约翰逊综合征,但它也可以满足抗惊厥超敏反应综合征或伴有嗜酸性粒细胞增多和全身体征的药疹的标准。一个精确地符合具有不同特征,不同治疗方法和不同预后的两种综合征的定义的案例表明,分类存在缺陷。

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