drug allergic stomatitis
Introduction
Introduction to drug allergic stomatitis Drug allergic stomatitis (allergicstomatitis) is an allergic disease of mucous membranes and skin caused by oral, injection or topical sputum, sputum and other different routes into the body, causing allergic reactions. Often manifested as a single or several blister of varying sizes, the blister formed a smash or ulcer after rupture, the surface has yellow-white exudate, the pain is obvious. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: erythema
Cause
The cause of drug allergic stomatitis
Cause (90%):
People with allergies develop symptoms due to allergic reactions caused by the use of drugs. Various drugs can cause allergic stomatitis. Common antibiotics such as penicillin, streptomycin, tetracycline, etc. and sulfonamides. Antipyretic analgesics, such as aspirin. Hypnotic and anti-epileptic drugs such as luminal, phenytoin and carbamazepine. Chinese patent medicines also cause allergic stomatitis, but they are much lower than Western medicine. Only a few drugs that cause drug allergic stomatitis are whole antigens, such as human gamma globulin, tetanus antitoxin, and certain vaccines. Most drugs and their metabolic breakdown products are haptens, which need to bind to the carrier protein of the macromolecule in the body to become a whole antigen. Drug antigens produce an allergic reaction by binding to or sensitizing lymphocytes.
Prevention
Drug allergic stomatitis prevention
Drug allergic stomatitis prevention is better than treatment, and the patient is told about the seriousness and danger of the drug that is exposed to the allergen again.
1. Do not abuse drugs. In particular, sulfa drugs, antipyretic analgesics, etc., which are susceptible to allergies.
2. Ask about the history of drug allergies. Those with a history of allergies do not need drugs with similar structures.
3. Establish a drug allergy card, let the patient keep in mind allergic drugs, and give it to the doctor as a reference for medication.
Complication
Drug allergic stomatitis complications Complications
Eye damage, damage to adjacent parts.
Symptom
Drug allergic stomatitis symptoms common symptoms oral mucosal ulcer oral mucosa soy ... pimples erythematous rash oral mucosal shedding oropharynx blister damage
Drug-induced allergic reactions require a certain incubation period, from the first 24 to 48 hours of onset, repeated episodes shortened to hours or minutes. The lesion can be caused by a single infection in the mouth or with skin damage. Oral lesions occur in the lips, cheeks, tongue and palate. Common lesions are single or several blister of different sizes. The blister forms a smash or ulcer after rupture, and there are yellow-white exudates on the surface, and the pain is obvious.
Skin lesions occur around the lips, face, lower limbs, palms and backs of hands and feet, and trunks, etc., often occur individually. It is characterized by erythema, papules, bullae, etc. The most common lesion is round erythema. Sometimes blisters appear on the basis of erythema, called erythematous erythema, the skin has itching discomfort, and the pain is not obvious. The lesion appears in a relatively fixed position, also known as a fixed drug rash. It is common in the skin around the lips and is mostly pigmented. It is dark red on the onset, and the edges are flush, round or oval.
Examine
Examination of drug allergic stomatitis
1. Patch test: Patch test is an auxiliary diagnostic method for measuring abnormal body reaction. According to the nature of the test substance, prepare an appropriate concentration of the infusion solution, solution, ointment or directly use the original as a reagent, soak the test solution with 4 layers of 1 cm2 gauze, or place the test object on the gauze, and place the forearm flexion side. Covered with slightly larger transparent cellophane, surrounded by adhesive plaster, removed after 48 hours, can induce local skin reaction, and the results were judged according to local skin performance at 72 hours.
2. Basophil granule degranulation test.
3. Lymphocyte conversion test of sensitizing substances.
4. Leukocyte movement inhibition test.
Diagnosis
Diagnosis and differentiation of drug allergic stomatitis
diagnosis
1. Have a clear history of medication or have a history of drug allergy.
2. Sudden acute inflammation, blistering of the oral mucosa, blistering to form a smashed surface, the edges are more neat. The skin has erythema, herpes and papules.
3. After the suspicious sensitizing drug is stopped, the lesion will heal quickly.
Differential diagnosis
Polymorphic exudative erythema
It is a group of acute inflammatory skin mucosal diseases involving skin and mucous membranes with target or iris-like erythema as typical lesions. It is self-limiting and often relapses. It happens in young and middle-aged, and it is more common in spring and autumn. Oral mucosal lesions can occur simultaneously with lesions and can occur separately. Oral lesions are widely distributed, which occur in the lips, cheeks, tongue, and sputum. Mucosal congestion and edema, sometimes visible erythema and blisters. But the blister quickly ruptures, so the most common lesion is a large area of erosion. The erosion surface has a large amount of exudate to form a thick pseudomembrane. The lesion is prone to bleeding, and thick black-purple blood stasis often forms in the lips.
Herpetic stomatitis
Primary infections are more common in infants and young children. The incubation period is about one week. The fever is 38 °C to 39 °C. The systemic reaction is heavier. Clusters of small blisters appear in any part of the oral mucosa and in the perioral skin.
