Zusammenfassung
Zum klinischen Spektrum schwerer kutaner Arzneimittelreaktionen zählen Erythema exsudativum majus (EEM), Stevens-Johnson-Syndrom (SJS) und die toxisch epidermale Nekrolyse (TEN). Insgesamt sind diese Krankheitsbilder selten (1–2/1 Mio./Jahr) und betreffen typischerweise Haut und Schleimhäute. Alle drei Erkrankungen unterscheiden sich durch das Ausmaß der Epidermolyse, wobei das Erythema exsudativum multiforme majus die mildere Verlaufsvariante und die toxisch epidermale Nekrolyse die Maximalvariante dieser kutanen Arzneiexantheme darstellen. Charakteristisch ist initial eine besondere Empfindlichkeit der Schleimhäute mit Einblutungen, Rötung und einer mehr oder weniger ausgeprägten Epidermolyse. In erster Linie sind Medikamente wie Allopurinol, Trimethoprim-Sulfamethoxazol, weitere Sulfonamide, Aminopenicilline, Cephalosporine, Chinolone, Carbamazepin, Phenytoin, Phenobarbital und nichtsteroidale Antiphlogistika die Ursachen dieser Krankheitsbilder. Darüber hinaus spielen vermutlich aber auch Infektionen, zum Beispiel durch Mycoplasma pneumoniae und Viren der Herpesgruppe, eine ätiologische Rolle.
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Hertl, M. (2018). Schwere kutane Arzneimittelreaktionen. In: Plewig, G., Ruzicka, T., Kaufmann, R., Hertl, M. (eds) Braun-Falco’s Dermatologie, Venerologie und Allergologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49544-5_36
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