摘要
本文报道一例中年女性患者,因反复皮疹6月余,自行使用多种外用药物治疗,或单用、或混用,致使皮损进行性加重,大面积皮肤破溃伴感染,创面呈侵袭性,并引发全身炎症反应,皮损总面积约30%TBSA。入院主要诊断:重度大面积皮肤溃疡伴全身炎症反应综合征。入院后,行多学科会诊(multi-disciplinary treatment,MDT),完善免疫学及相关炎症指标等检查,排除自身免疫性及免疫缺陷疾病,予以全身综合性治疗、创面个性化序贯治疗、全程分阶段的精准心理干预等。住院1月余,患者创面愈合,痊愈出院。本文对发病原因、全身与局部治疗、机体与心理治疗、重视免疫系统功能评估、加强OTC药物销售管理与使用宣教等相关问题进行了讨论。
This paper reports the case of a middle-aged female patient who used a variety of topical medications alone or in combination because of repeated rashes for more than 6 months,which resulted in progressive aggravation of skin lesions,extensive skin ulceration with infection,invasive wound surface,and systemic inflammatory reaction.The lesions involved 30%of total body surface area.The main diagnosis at admission was severe large area skin ulcer with systemic inflammatory response syndrome.After admission,multi-disciplinary consultation was performed,related immunologic and inflammatory indicators were detected,autoimmune and immunodeficiency diseases were excluded,and systemic comprehensive treatment,personalized sequential treatment of wounds,and precise psychological intervention in stages were applied.After being hospitalized for more than one month,the patient recovered and was discharged.This paper discusses the causes of the disease,systemic and local treatment,and physical and psychological therapy,highlighting the evaluation of immune system function,management of OTC drug sales,and medication use education.
作者
赵喜迎
吴贝贝
叶敬成
孙炳伟
谢尔凡
Zhao Xiying;Wu Beibei;Ye Jingcheng;Sun Bingwei;Xie Erfan(Department of Burn and Wound Repair,Suzhou BenQ Medical Center,The Affiliated BenQ Hospital of Nanjing Medical University,Suzhou 215010,China;Department of Burn and Plastic Surgery,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215008,China)
出处
《中华临床医师杂志（电子版）》
CAS
2024年第3期328-332,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
皮肤溃疡
皮肤感染
药物滥用
Skin ulcer
Skin infection
Medication misuse
作者简介
通信作者:谢尔凡,Email:erfan_xie@126.com。
