비스테로이드 소염제 사용 후 나타난 독성 표피 괴사 융해증 1례 (A Case of Toxic Epidermal Necrolysis (TEN) Induced by Nonsteroidal Anti- Inflammatory Drug (NSAID))

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 2호 / 227 ~ 230페이지
· 저자명 : 김선표, 김성중, 최연규, 조수형, 조남수

초록

A patient who was transferred to our Emergency Medical
Center from a local clinic with a dermatologic disorder of
unknown origin presented to us with TEN with a 40% skin
slough. The patient was a 53-year-old women with complaints
of erythematous rash and blisters on her trunk and
both proximal extremities. She had taken NSAIDS, 1300 mg
per oral, every 8 h for 5 days. Five days after administration
of NSAIDS began, the doctors at the local clinic noted that a
rash with blisters had begun on her back and progressed to
her extremities. After 4 days of that progression she came to
us. On physical examination, she had asymptomatic multiple
clear filled bullae and erosion with brown- to black-colored
hyperpigmentation on her trunk and proximal extremities
involving 40% of the body surface. She was admitted to a
private room to prevent secondary infections, and her management
included fluid replacement, third-generation
cephalosporin and corticosteroid administration, and intensive
wound care. Fifteen days after admission, no further
treatment was required, and only a small scar and a mild
dispigmentation lesion could be seen.
Emergency department physicians should think about TEN
if the patient has extensive exfolating skin lesions.
Treatment of patients with suspected TEN must be directed
at minimizing fluid and electrolyte loss and preventing secondary
infection, and an effort should be made to identify the
suspicious drug and to educate patient to avoid the drug.

영어초록

A patient who was transferred to our Emergency Medical
Center from a local clinic with a dermatologic disorder of
unknown origin presented to us with TEN with a 40% skin
slough. The patient was a 53-year-old women with complaints
of erythematous rash and blisters on her trunk and
both proximal extremities. She had taken NSAIDS, 1300 mg
per oral, every 8 h for 5 days. Five days after administration
of NSAIDS began, the doctors at the local clinic noted that a
rash with blisters had begun on her back and progressed to
her extremities. After 4 days of that progression she came to
us. On physical examination, she had asymptomatic multiple
clear filled bullae and erosion with brown- to black-colored
hyperpigmentation on her trunk and proximal extremities
involving 40% of the body surface. She was admitted to a
private room to prevent secondary infections, and her management
included fluid replacement, third-generation
cephalosporin and corticosteroid administration, and intensive
wound care. Fifteen days after admission, no further
treatment was required, and only a small scar and a mild
dispigmentation lesion could be seen.
Emergency department physicians should think about TEN
if the patient has extensive exfolating skin lesions.
Treatment of patients with suspected TEN must be directed
at minimizing fluid and electrolyte loss and preventing secondary
infection, and an effort should be made to identify the
suspicious drug and to educate patient to avoid the drug.

참고자료

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