CAJ | 학술논문

1例90岁男性患者因高血压病、血管性痴呆口服苯磺酸氨氯地平、盐酸多奈哌齐、奥氮平,后加用托吡酯25 mg,2次/d控制易激惹等精神行为异常.托吡酯治疗后第22天,患者出现全身皮肤轻度发红,予甲泼尼龙20 mg,1次/d静脉滴注.13 d后出现全身弥漫性红斑伴瘙痒、部分红斑融合.5d后进展为大片皮肤表皮脱落.诊断为剥脱性皮炎.停用托吡酯,甲泼尼龙剂量加倍并外用氧化锌洗剂,同时给予抗炎、补充白蛋白等对症支持处理.12 d后,皮疹消退.
1례90세남성환자인고혈압병、혈관성치태구복분광산안록지평、염산다내고제、오담평,후가용탁필지25 mg,2차/d공제역격야등정신행위이상.탁필지치료후제22천,환자출현전신피부경도발홍,여갑발니룡20 mg,1차/d정맥적주.13 d후출현전신미만성홍반반소양、부분홍반융합.5d후진전위대편피부표피탈락.진단위박탈성피염.정용탁필지,갑발니룡제량가배병외용양화자세제,동시급여항염、보충백단백등대증지지처리.12 d후,피진소퇴.
A 90-year-old male patient with hypertension and vascular dementia was treated with amlodipine besilate,donepezil hydrochloride and olanzapine.Oral topiramate 25 mg twice daily was added to his regimen due to irritability and other abnormal mental status and behaviors.On day 22 of treatment with topiramate,he developed generalized flushing.An infusion of methylprednisolone 20 mg once daily was given.After 13 days,diffuse erythema involving his entire body with pruritus and partial plaques fusion developed.His symptoms progressed to large areas of skin exfoliation after 5 days.Exfoliative dermatitis was diagnosed.Topiramate was stopped and he was treated with methylprednisolone double dosage and topical zinc oxide lotion.At the same time,he received symptomatic treatment and supportive therapy such as antiinflammatory and albumin supplement.Twelve days later,patient's rash subsided.