TOXIDERMII

DOI: 10.7241/ourd.2022book.2_10

First Page (Prima pagina)

Reac?iile cutanate post-medicamentoase sunt foarte frecvente la copii: 1-10% din copiii trata?i cu betalactamine au prezentat erup?ie cutanată, dar cu un risc de recidivă de sub 10% [1,2].
Clasificarea reac?iilor alergice (Gell et Coombs revizuită de Pichler) [3]:
1. Reac?ie alergică de tip I (imediată, mediată de IgE)

Acest tip de reac?ie alergică este mediat de IgE specifice unui antigen (Ag), care se fixează pe mastocite ?i determină degranulare mastocitară. Sindromul de degranulare mastocitară se manifestă clinic rapid, imediat sau în prima oră după expunere (în cazul toxidermiei-priza de medicament). Clinic specific este tabloul de tip urticarie acută ?i/sau angioedem. Uneori, la copii, leziunile de urticarie au aspect intens eritematos-echimotic ?i sunt de tip inelar. Reac?ia cutanată post-medicamentoasă poate fi precedată de prurit palmo-plantar, cu sau fără eritem, semn sugestiv de reac?ie alergică. Celelalte semne de degranulare mastocitară pot fi prezente, în diferite grade de severitate. Orice medicament poate determina o astfel de reac?ie, cel mai des implica?i sunt: betalactaminele, paracetamol, AINS, alte antibiotice.

Keywords

  • alergice; EXANTEM MACULO-PAPULOS; PUSTULOZĂ EXANTEMATICĂ ACUTĂ GENERALIZATĂ; NECROLIZĂ EPIDERMICĂ TOXICĂ; Sindrom Stevens-Johnson; Sindrom Lyell; Sindrom overlap; DRESS

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