皮肤性

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保妥适面部注射除皱致全身过敏性皮疹一例

2018-02-20 佚名 中国美容整形外科杂志

保妥适过敏
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患者女性，35岁

【一般资料】

患者女性，35岁

【主诉】

因上面部皱纹增多第1次行肉毒毒素治疗

【个人史】

否认既往药物过敏史。

【现病史】

BOTOX?100U溶于2.0ml生理盐水中，额部、眉问纹、鱼尾纹共注射80u。注射后40h，患者肩背部开始出现米粒大小的红色皮疹，并逐渐蔓延至侧胸腹部，无其他不适。2d后皮疹开始明显增多，伴有瘙痒感，且范围扩大并累及到躯干和四肢（图1），以背部表现最为明显，皮疹融合成片（图2），包括注射区在内的头面部未见明显皮疹。患者开始出现发热症状，体温最高达38.4℃，伴有头痛、寒颤。患者就诊于外院，血常规检查大致正常，否认BOTOX?注射前后期曾更换化妆品、食用特殊食物、服用特殊药物。

【初步诊断】

诊断考虑为BOTOX?注射引起的过敏反应

【治疗经过】

开始口服氯雷他定，同时抽血查lgE。4d后患者体温恢复正常；7d后皮疹开始消退，以躯干部病灶消退最快，咂IgE结果显示2122IU/ml（参考值1~165），支持过敏诊断，继续口服抗过敏药物；16d后皮疹完全消退。


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#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2046942, encodeId=e1a62046942be, content=<a href='/topic/show?id=6f5294036b1' target=_blank style='color:#2F92EE;'>#过敏性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94036, encryptionId=6f5294036b1, topicName=过敏性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a8e213, createdName=hongbochen, createdTime=Mon Jul 09 22:14:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292564, encodeId=13572925645a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Mar 03 09:47:43 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289689, encodeId=203f28968926, content=努力学习.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Feb 21 10:13:03 CST 2018, time=2018-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289480, encodeId=ae6a2894802f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Feb 20 18:26:06 CST 2018, time=2018-02-20, status=1, ipAttribution=)]
    2018-07-09 hongbochen

    #过敏性#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2046942, encodeId=e1a62046942be, content=<a href='/topic/show?id=6f5294036b1' target=_blank style='color:#2F92EE;'>#过敏性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94036, encryptionId=6f5294036b1, topicName=过敏性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a8e213, createdName=hongbochen, createdTime=Mon Jul 09 22:14:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292564, encodeId=13572925645a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Mar 03 09:47:43 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289689, encodeId=203f28968926, content=努力学习.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Feb 21 10:13:03 CST 2018, time=2018-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289480, encodeId=ae6a2894802f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Feb 20 18:26:06 CST 2018, time=2018-02-20, status=1, ipAttribution=)]
    2018-03-03 龙胆草

    学习谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2046942, encodeId=e1a62046942be, content=<a href='/topic/show?id=6f5294036b1' target=_blank style='color:#2F92EE;'>#过敏性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94036, encryptionId=6f5294036b1, topicName=过敏性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a8e213, createdName=hongbochen, createdTime=Mon Jul 09 22:14:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292564, encodeId=13572925645a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Mar 03 09:47:43 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289689, encodeId=203f28968926, content=努力学习.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Feb 21 10:13:03 CST 2018, time=2018-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289480, encodeId=ae6a2894802f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Feb 20 18:26:06 CST 2018, time=2018-02-20, status=1, ipAttribution=)]
    2018-02-21 忠诚向上

    努力学习.好好看下

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2046942, encodeId=e1a62046942be, content=<a href='/topic/show?id=6f5294036b1' target=_blank style='color:#2F92EE;'>#过敏性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94036, encryptionId=6f5294036b1, topicName=过敏性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a8e213, createdName=hongbochen, createdTime=Mon Jul 09 22:14:00 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=292564, encodeId=13572925645a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Mar 03 09:47:43 CST 2018, time=2018-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289689, encodeId=203f28968926, content=努力学习.好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Wed Feb 21 10:13:03 CST 2018, time=2018-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289480, encodeId=ae6a2894802f, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Tue Feb 20 18:26:06 CST 2018, time=2018-02-20, status=1, ipAttribution=)]
    2018-02-20 131****1460

    学习了受益匪浅

    0