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

:开始使用拉莫三嗪治疗2周后,一名43岁的男子出现了以史蒂文斯-约翰逊综合症为特征的“具有水泡的斑疹”以及嘴唇和颊粘膜糜烂的皮肤疹。他发烧(39.6摄氏度),外周血肝酶和非典型淋巴细胞增多。这无疑反映了拉莫三嗪引起的史蒂文斯-约翰逊综合症,但它也可以满足抗惊厥超敏综合症或嗜酸性粒细胞增多和全身性症状的皮疹的标准。一个病例恰好符合两种具有不同特征,不同治疗方法和不同预后的综合症的定义,表明该分类存在缺陷。

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