Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
권호 표지
DOI QR코드

DOI QR Code

Three Cases of Erythema Multiforme Developed during Deflazacort Therapy in Children with Nephrotic Syndrome

소아 신증후군 환자에서 데플라자코트 치료 중 발생된 다형 홍반 3례

  • Lee, Seung Jin (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Kang, Bong Hwa (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Cho, Min Hyun (Department of Pediatrics, Kyungpook National University School of Medicine)
  • 이승진 (경북대학교 의학전문대학원 소아과학교실) ;
  • 강봉화 (경북대학교 의학전문대학원 소아과학교실) ;
  • 조민현 (경북대학교 의학전문대학원 소아과학교실)
  • Received : 2014.05.27
  • Accepted : 2014.07.15
  • Published : 2014.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Erythema multiforme (EM) is an acute mucocutaneous disorder involving the skin, mouth, eyes, and genital organs. It is classified into EM minor and EM major according to the involvement of the mucosal membrane. Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) belong to EM major. Compared to EM minor, SJS presents with more severe and progressive symptoms, and has a higher mortality rate. Corticosteroids are used in the treatment of EM. We report three cases of EM (two cases of EM minor and one case of SJS) that developed during treatment with oral corticosteroid (deflazacort; $Calcort^{(R)}$) in children with nephrotic syndrome.

다형 홍반은 피부, 구강, 입술 및 생식기 등을 침범하는 급성 피부점막 질환으로 점막 침범 여부에 따라 다형 홍반 minor와 다형 홍반 major로 분류된다. 스티븐스-존슨 증후군과 독성표피괴사용해는 다형 홍반 major에 속하는데, 이들은 증상이 심하고 진행성이며 높은 사망률을 보인다. 코르티코스테로이드는 현재 다형 홍반의 치료제로 사용되고 있다. 저자들은 신증후군을 가진 소아 환자에서 경구 코르티코스테로이드인 데플라자코트를 사용하던 중 발생된 3개의 다형 홍반 증례를 보고하는 바이다.

Keywords

References

  1. Huff JC, Weston WL, Tonnesen MG. Erythema multiforme: a critical review of characteristics, diagnostic criteria, and causes. J Am Acad Dermatol 1983;8:763-75. https://doi.org/10.1016/S0190-9622(83)80003-6
  2. Farthing P, Bagan JV, Scully C. Mucosal disease series. Number IV. Erythema multiforme. Oral dis 2005;11:261-7. https://doi.org/10.1111/j.1601-0825.2005.01141.x
  3. Roujeau JC. Stevens-Johnson syndrome and toxic epidermal necrolysis are severity variants of the same disease which differs from erythema multiforme. J Dermatol 1997;24:726-9. https://doi.org/10.1111/j.1346-8138.1997.tb02524.x
  4. Mockenhaupt M. The current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis. Expert Rev Clin Immunol 2011;7:803-15. https://doi.org/10.1586/eci.11.66
  5. Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern RS, Anderson T, et al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. N Engl J Med 1995; 333:1600-7. https://doi.org/10.1056/NEJM199512143332404
  6. Araki Y, Sotozono C, Inatomi T, Ueta M, Yokoi N, Ueda E, et al. Successful treatment of Stevens-Johnson syndrome with steroid pulse therapy at disease onset. Am J Ophthalmol 2009;147:1004-11. https://doi.org/10.1016/j.ajo.2008.12.040
  7. Joshi N, Rajeshwari K. Deflazacort. J Postgrad Med 2009;55:296-300. https://doi.org/10.4103/0022-3859.58942
  8. Nayak S, Acharjya B. Deflazacort versus other glucocorticoids: a comparison. Indian J Dermatol 2008;53:167-70. https://doi.org/10.4103/0019-5154.44786
  9. Del Pozzo-Magana BR, Lazo-Langner A, Carleton B, Castro-Pastrana LI, Rieder MJ. A systemic review of treatment of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in children. J Popul Ther Clin Pharmacol 2011;18:121-33.
  10. Jo DS, Yang JW, Hwang PH, Lee DY. Stevens-Johnson syndrome in a boy with nephritic syndrome during prednisolone therapy. Pediatr Nephrol 2003;18:959-61. https://doi.org/10.1007/s00467-003-1215-0