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Острые состояния в дерматологии: токсические реакции и их терапия
Острые состояния в дерматологии: токсические реакции и их терапия
Сакания Л.Р., Плиева К.Т., Денисова Е.В., Корсунская И.М. Острые состояния в дерматологии: токсические реакции и их терапия. Consilium Medicum. 2021; 23 (8): 668–671. DOI: 10.26442/20751753.2021.8.201180
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Аннотация
Особую сложность в дерматологической практике представляют острые тяжелые состояния, вызванные применением разных лекарственных средств. В группу токсикодермических реакций входят такие состояния, как DRESS-синдром, синдром Стивенса–Джонсона, токсический эпидермальный некролиз, острый генерализованный экзантематозный пустулез и эритродермии разного генеза. Опасность представляет не только кожный процесс, но и развитие токсических реакций внутренних органов, что в свою очередь без надлежащей терапии уже может привести к летальному исходу. Препаратами 1-го выбора при подобных реакциях становятся системные глюкокортикостероиды, в частности производные бетаметазона. Собственный опыт и многочисленные исследования подтверждают эффективность таких препаратов. Однако стоит помнить, что бесконтрольное или длительное применение системных глюкокортикостероидов может усугубить состояние пациента и повлечь за собой нежелательные побочные реакции.
Ключевые слова: токсидермия, эритродермия, лекарственные реакции, системные глюкокортикостероиды, бетаметазон
Key words: toxidermia, erythroderma, drug reactions, systemic glucocorticosteroids, betamethasone
Ключевые слова: токсидермия, эритродермия, лекарственные реакции, системные глюкокортикостероиды, бетаметазон
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Key words: toxidermia, erythroderma, drug reactions, systemic glucocorticosteroids, betamethasone
Полный текст
Список литературы
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13. César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10(1):1-9. DOI:10.3315/jdcr.2016.1222
14. Rice AS, Crane JS. Epidermolytic Hyperkeratosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.
15. Tan GF, Kong YL, Tan AS, Tey HL. Causes and features of erythroderma. Ann Acad Med Singap. 2014;43(8):391-4.
16. Banerjee S, Ghosh S, Mandal RK. A Study of Correlation Between Clinical and Histopathological Findings of Erythroderma in North Bengal Population. Indian J Dermatol. 2015;60(6):549-55. DOI:10.4103/0019-5154.169124
17. Sehgal VN, Srivastava G. Exfoliative dermatitis. A prospective study of 80 patients. Dermatologica. 1986;173(6):278-84.
18. Mistry N, Gupta A, Alavi A, Sibbald RG. A review of the diagnosis and management of erythroderma (generalized red skin). Adv Skin Wound Care. 2015;28(5):228-36; quiz 237-8. DOI:10.1097/01.ASW.0000463573.40637.73
19. Karakayli G, Beckham G, Orengo I, Rosen T. Exfoliative dermatitis. Am Fam Physician. 1999;59(3):625-30.
20. Daudén E, Bewley A, Lambert J, et al. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis. J Eur Acad Dermatol Venereol. 2014;28(Suppl. 2):22-32. DOI:10.1111/jdv.12443
21. Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet. 2005;44(1):61-98. DOI:10.2165/00003088-200544010-00003
22. He C, Fan H, Tan J, et al. Pharmacokinetics of betamethasone and betamethasone 17-monopropionate in Chinese healthy volunteers after intramuscular injection of betamethasone phosphate/betamethasone dipropionate. Arzneimittelforschung. 2011;61(7):417-20. DOI:10.1055/s-0031-1296220
23. Salem II, Najib NM. Pharmacokinetics of betamethasone after single-dose intramuscular administration of betamethasone phosphate and betamethasone acetate to healthy subjects. Clin Ther. 2012;34(1):214-20. DOI:10.1016/j.clinthera.2011.11.022
24. Simon A, de Almeida Borges VR, Cabral LM, de Sousa VP. Development and validation of a discriminative dissolution test for betamethasone sodium phosphate and betamethasone dipropionate intramuscular injectable suspension. AAPS PharmSciTech. 2013;14(1):425-34. DOI:10.1208/s12249-012-9920-2
25. Zou JJ, Dai L, Ding L, et al. Determination of betamethasone and betamethasone 17-monopropionate in human plasma by liquid chromatography-positive/negative electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2008;873(2):159-64.
26. Jobe AH, Milad MA, Peppard T, Jusko WJ. Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India. Clin Transl Sci. 2020;13(2):391-9. DOI:10.1111/cts.12724
2. Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1999;83(6 Pt. 3):665-700.
3. DeShazo RD, Kemp SF. Allergic reactions to drugs and biologic agents. JAMA. 1997;278(22):1895-906.
4. Niebel D, Wenzel J. Immunopathology of cutaneous drug eruptions. Pathologe. 2018;39(6):563-70.
5. Graudins LV, Trubiano JA, Zubrinich CM, et al. Medication-related anaphylaxis treated in hospital: Agents implicated, patient outcomes, and management lessons. Pharmacoepidemiol Drug Saf. 2018;27(9):1029-33.
6. Formica D, Sultana J, Cutroneo PM, et al. The economic burden of preventable adverse drug reactions: a systematic review of observational studies. Expert Opin Drug Saf. 2018;17(7):681-95.
7. Aung AK, Tang MJ, Adler NR, et al. Adverse Drug Reactions Reported by Healthcare Professionals: Reaction Characteristics and Time to Reporting. J Clin Pharmacol. 2018;58(10):1332-9.
8. Allegaert K, Smits A, van den Anker JN. Drug evaluation studies in neonates: how to overcome the current limitations. Expert Rev Clin Pharmacol. 2018;11(4):387-96.
9. Van Schandevyl G, Bauters T. Thiotepa-induced cutaneous toxicity in pediatric patients: Case report and implementation of preventive care guidelines. J Oncol Pharm Pract. 2019;25(3):689-93.
10. Amsler E, Soria A. Hypersensitivity reactions to beta-lactam antibiotics. Rev Med Interne. 2017;38(11):737-48.
11. Okoduwa C, Lambert WC, Schwartz RA, et al. Erythroderma: review of a potentially life-threatening dermatosis. Indian J Dermatol. 2009;54(1):1-6. DOI:10.4103/0019-5154.48976
12. Akhyani M, Ghodsi ZS, Toosi S, Dabbaghian H. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5:5. DOI:10.1186/1471-5945-5-5
13. César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10(1):1-9. DOI:10.3315/jdcr.2016.1222
14. Rice AS, Crane JS. Epidermolytic Hyperkeratosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.
15. Tan GF, Kong YL, Tan AS, Tey HL. Causes and features of erythroderma. Ann Acad Med Singap. 2014;43(8):391-4.
16. Banerjee S, Ghosh S, Mandal RK. A Study of Correlation Between Clinical and Histopathological Findings of Erythroderma in North Bengal Population. Indian J Dermatol. 2015;60(6):549-55. DOI:10.4103/0019-5154.169124
17. Sehgal VN, Srivastava G. Exfoliative dermatitis. A prospective study of 80 patients. Dermatologica. 1986;173(6):278-84.
18. Mistry N, Gupta A, Alavi A, Sibbald RG. A review of the diagnosis and management of erythroderma (generalized red skin). Adv Skin Wound Care. 2015;28(5):228-36; quiz 237-8. DOI:10.1097/01.ASW.0000463573.40637.73
19. Karakayli G, Beckham G, Orengo I, Rosen T. Exfoliative dermatitis. Am Fam Physician. 1999;59(3):625-30.
20. Daudén E, Bewley A, Lambert J, et al. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis. J Eur Acad Dermatol Venereol. 2014;28(Suppl. 2):22-32. DOI:10.1111/jdv.12443
21. Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet. 2005;44(1):61-98. DOI:10.2165/00003088-200544010-00003
22. He C, Fan H, Tan J, et al. Pharmacokinetics of betamethasone and betamethasone 17-monopropionate in Chinese healthy volunteers after intramuscular injection of betamethasone phosphate/betamethasone dipropionate. Arzneimittelforschung. 2011;61(7):417-20. DOI:10.1055/s-0031-1296220
23. Salem II, Najib NM. Pharmacokinetics of betamethasone after single-dose intramuscular administration of betamethasone phosphate and betamethasone acetate to healthy subjects. Clin Ther. 2012;34(1):214-20. DOI:10.1016/j.clinthera.2011.11.022
24. Simon A, de Almeida Borges VR, Cabral LM, de Sousa VP. Development and validation of a discriminative dissolution test for betamethasone sodium phosphate and betamethasone dipropionate intramuscular injectable suspension. AAPS PharmSciTech. 2013;14(1):425-34. DOI:10.1208/s12249-012-9920-2
25. Zou JJ, Dai L, Ding L, et al. Determination of betamethasone and betamethasone 17-monopropionate in human plasma by liquid chromatography-positive/negative electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2008;873(2):159-64.
26. Jobe AH, Milad MA, Peppard T, Jusko WJ. Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India. Clin Transl Sci. 2020;13(2):391-9. DOI:10.1111/cts.12724
2. Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1999;83(6 Pt. 3):665-700.
3. DeShazo RD, Kemp SF. Allergic reactions to drugs and biologic agents. JAMA. 1997;278(22):1895-906.
4. Niebel D, Wenzel J. Immunopathology of cutaneous drug eruptions. Pathologe. 2018;39(6):563-70.
5. Graudins LV, Trubiano JA, Zubrinich CM, et al. Medication-related anaphylaxis treated in hospital: Agents implicated, patient outcomes, and management lessons. Pharmacoepidemiol Drug Saf. 2018;27(9):1029-33.
6. Formica D, Sultana J, Cutroneo PM, et al. The economic burden of preventable adverse drug reactions: a systematic review of observational studies. Expert Opin Drug Saf. 2018;17(7):681-95.
7. Aung AK, Tang MJ, Adler NR, et al. Adverse Drug Reactions Reported by Healthcare Professionals: Reaction Characteristics and Time to Reporting. J Clin Pharmacol. 2018;58(10):1332-9.
8. Allegaert K, Smits A, van den Anker JN. Drug evaluation studies in neonates: how to overcome the current limitations. Expert Rev Clin Pharmacol. 2018;11(4):387-96.
9. Van Schandevyl G, Bauters T. Thiotepa-induced cutaneous toxicity in pediatric patients: Case report and implementation of preventive care guidelines. J Oncol Pharm Pract. 2019;25(3):689-93.
10. Amsler E, Soria A. Hypersensitivity reactions to beta-lactam antibiotics. Rev Med Interne. 2017;38(11):737-48.
11. Okoduwa C, Lambert WC, Schwartz RA, et al. Erythroderma: review of a potentially life-threatening dermatosis. Indian J Dermatol. 2009;54(1):1-6. DOI:10.4103/0019-5154.48976
12. Akhyani M, Ghodsi ZS, Toosi S, Dabbaghian H. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5:5. DOI:10.1186/1471-5945-5-5
13. César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10(1):1-9. DOI:10.3315/jdcr.2016.1222
14. Rice AS, Crane JS. Epidermolytic Hyperkeratosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.
15. Tan GF, Kong YL, Tan AS, Tey HL. Causes and features of erythroderma. Ann Acad Med Singap. 2014;43(8):391-4.
16. Banerjee S, Ghosh S, Mandal RK. A Study of Correlation Between Clinical and Histopathological Findings of Erythroderma in North Bengal Population. Indian J Dermatol. 2015;60(6):549-55. DOI:10.4103/0019-5154.169124
17. Sehgal VN, Srivastava G. Exfoliative dermatitis. A prospective study of 80 patients. Dermatologica. 1986;173(6):278-84.
18. Mistry N, Gupta A, Alavi A, Sibbald RG. A review of the diagnosis and management of erythroderma (generalized red skin). Adv Skin Wound Care. 2015;28(5):228-36; quiz 237-8. DOI:10.1097/01.ASW.0000463573.40637.73
19. Karakayli G, Beckham G, Orengo I, Rosen T. Exfoliative dermatitis. Am Fam Physician. 1999;59(3):625-30.
20. Daudén E, Bewley A, Lambert J, et al. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis. J Eur Acad Dermatol Venereol. 2014;28(Suppl. 2):22-32. DOI:10.1111/jdv.12443
21. Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet. 2005;44(1):61-98. DOI:10.2165/00003088-200544010-00003
22. He C, Fan H, Tan J, et al. Pharmacokinetics of betamethasone and betamethasone 17-monopropionate in Chinese healthy volunteers after intramuscular injection of betamethasone phosphate/betamethasone dipropionate. Arzneimittelforschung. 2011;61(7):417-20. DOI:10.1055/s-0031-1296220
23. Salem II, Najib NM. Pharmacokinetics of betamethasone after single-dose intramuscular administration of betamethasone phosphate and betamethasone acetate to healthy subjects. Clin Ther. 2012;34(1):214-20. DOI:10.1016/j.clinthera.2011.11.022
24. Simon A, de Almeida Borges VR, Cabral LM, de Sousa VP. Development and validation of a discriminative dissolution test for betamethasone sodium phosphate and betamethasone dipropionate intramuscular injectable suspension. AAPS PharmSciTech. 2013;14(1):425-34. DOI:10.1208/s12249-012-9920-2
25. Zou JJ, Dai L, Ding L, et al. Determination of betamethasone and betamethasone 17-monopropionate in human plasma by liquid chromatography-positive/negative electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2008;873(2):159-64.
26. Jobe AH, Milad MA, Peppard T, Jusko WJ. Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India. Clin Transl Sci. 2020;13(2):391-9. DOI:10.1111/cts.12724
________________________________________________
2. Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1999;83(6 Pt. 3):665-700.
3. DeShazo RD, Kemp SF. Allergic reactions to drugs and biologic agents. JAMA. 1997;278(22):1895-906.
4. Niebel D, Wenzel J. Immunopathology of cutaneous drug eruptions. Pathologe. 2018;39(6):563-70.
5. Graudins LV, Trubiano JA, Zubrinich CM, et al. Medication-related anaphylaxis treated in hospital: Agents implicated, patient outcomes, and management lessons. Pharmacoepidemiol Drug Saf. 2018;27(9):1029-33.
6. Formica D, Sultana J, Cutroneo PM, et al. The economic burden of preventable adverse drug reactions: a systematic review of observational studies. Expert Opin Drug Saf. 2018;17(7):681-95.
7. Aung AK, Tang MJ, Adler NR, et al. Adverse Drug Reactions Reported by Healthcare Professionals: Reaction Characteristics and Time to Reporting. J Clin Pharmacol. 2018;58(10):1332-9.
8. Allegaert K, Smits A, van den Anker JN. Drug evaluation studies in neonates: how to overcome the current limitations. Expert Rev Clin Pharmacol. 2018;11(4):387-96.
9. Van Schandevyl G, Bauters T. Thiotepa-induced cutaneous toxicity in pediatric patients: Case report and implementation of preventive care guidelines. J Oncol Pharm Pract. 2019;25(3):689-93.
10. Amsler E, Soria A. Hypersensitivity reactions to beta-lactam antibiotics. Rev Med Interne. 2017;38(11):737-48.
11. Okoduwa C, Lambert WC, Schwartz RA, et al. Erythroderma: review of a potentially life-threatening dermatosis. Indian J Dermatol. 2009;54(1):1-6. DOI:10.4103/0019-5154.48976
12. Akhyani M, Ghodsi ZS, Toosi S, Dabbaghian H. Erythroderma: a clinical study of 97 cases. BMC Dermatol. 2005;5:5. DOI:10.1186/1471-5945-5-5
13. César A, Cruz M, Mota A, Azevedo F. Erythroderma. A clinical and etiological study of 103 patients. J Dermatol Case Rep. 2016;10(1):1-9. DOI:10.3315/jdcr.2016.1222
14. Rice AS, Crane JS. Epidermolytic Hyperkeratosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021.
15. Tan GF, Kong YL, Tan AS, Tey HL. Causes and features of erythroderma. Ann Acad Med Singap. 2014;43(8):391-4.
16. Banerjee S, Ghosh S, Mandal RK. A Study of Correlation Between Clinical and Histopathological Findings of Erythroderma in North Bengal Population. Indian J Dermatol. 2015;60(6):549-55. DOI:10.4103/0019-5154.169124
17. Sehgal VN, Srivastava G. Exfoliative dermatitis. A prospective study of 80 patients. Dermatologica. 1986;173(6):278-84.
18. Mistry N, Gupta A, Alavi A, Sibbald RG. A review of the diagnosis and management of erythroderma (generalized red skin). Adv Skin Wound Care. 2015;28(5):228-36; quiz 237-8. DOI:10.1097/01.ASW.0000463573.40637.73
19. Karakayli G, Beckham G, Orengo I, Rosen T. Exfoliative dermatitis. Am Fam Physician. 1999;59(3):625-30.
20. Daudén E, Bewley A, Lambert J, et al. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis. J Eur Acad Dermatol Venereol. 2014;28(Suppl. 2):22-32. DOI:10.1111/jdv.12443
21. Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clin Pharmacokinet. 2005;44(1):61-98. DOI:10.2165/00003088-200544010-00003
22. He C, Fan H, Tan J, et al. Pharmacokinetics of betamethasone and betamethasone 17-monopropionate in Chinese healthy volunteers after intramuscular injection of betamethasone phosphate/betamethasone dipropionate. Arzneimittelforschung. 2011;61(7):417-20. DOI:10.1055/s-0031-1296220
23. Salem II, Najib NM. Pharmacokinetics of betamethasone after single-dose intramuscular administration of betamethasone phosphate and betamethasone acetate to healthy subjects. Clin Ther. 2012;34(1):214-20. DOI:10.1016/j.clinthera.2011.11.022
24. Simon A, de Almeida Borges VR, Cabral LM, de Sousa VP. Development and validation of a discriminative dissolution test for betamethasone sodium phosphate and betamethasone dipropionate intramuscular injectable suspension. AAPS PharmSciTech. 2013;14(1):425-34. DOI:10.1208/s12249-012-9920-2
25. Zou JJ, Dai L, Ding L, et al. Determination of betamethasone and betamethasone 17-monopropionate in human plasma by liquid chromatography-positive/negative electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2008;873(2):159-64.
26. Jobe AH, Milad MA, Peppard T, Jusko WJ. Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India. Clin Transl Sci. 2020;13(2):391-9. DOI:10.1111/cts.12724
Авторы
Л.Р. Сакания1,2, К.Т. Плиева2, Е.В. Денисова1,2, И.М. Корсунская*1,2
1 ФГБУН «Центр теоретических проблем физико-химической фармакологии» РАН, Москва, Россия;
2 ГБУЗ «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения г. Москвы, Москва, Россия
*marykor@bk.ru
1 Center for Theoretical Problems of Physicochemical Pharmacology, Moscow, Russia;
2 Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology, Moscow, Russia
*marykor@bk.ru
1 ФГБУН «Центр теоретических проблем физико-химической фармакологии» РАН, Москва, Россия;
2 ГБУЗ «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения г. Москвы, Москва, Россия
*marykor@bk.ru
________________________________________________
1 Center for Theoretical Problems of Physicochemical Pharmacology, Moscow, Russia;
2 Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology, Moscow, Russia
*marykor@bk.ru
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