Makülopapüler Ekzantem ve DRESS

Ceyda TUNAKAN DALGIÇa, Aytül Zerrin SİNb
aSivas Cumhuriyet Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Hastalıkları BD, Sivas,TÜRKİYE
bEge Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Hastalıkları BD, İzmir, TÜRKİYE

Tunakan Dalgıç C, Sin AZ. Makülopapüler ekzantem ve DRESS. Çildağ S, editör. İmmünolojik ve Alerjik Deri Hastalıkları. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.48-56.

ÖZET
Makülopapüler Ekzantem (MPE), morbiliform veya makülopapüler ilaç erüpsiyonu olarak da adlandırılan ekzantematöz bir hipersensitivitesi reaksiyonudur. İlaç tedavisinin başlanmasından sonra, yaklaşık bir hafta 10 gün içinde ortaya çıkan diffüz ve simetrik eritematöz maküler veya küçük papüler erüpsiyonlarla karakterizedir. Eğer kişi ilacı kullanıp daha önce duyarlanmış ise, ilacın alınmasını takiben bir veya iki gün içinde lezyonlar ortaya çıkabilir. DRESS (Drug reaction with eosinophilia and systemic symptoms: sistemik semptomlar ve eozinofili ile beraber görülen ilaç reaksiyonu) ise, nadir görülen, potansiyel olarak hayatı tehdit edebilen, deri döküntüsü, hematolojik anormallikler (eozinofili, atipik lenfositoz), lenfadenopati ve iç organ tutuluşu (karaciğer, böbrek, akciğer) bulgularını içeren ilaç hipersensitivite reaksiyonudur. İlacın kullanılması ile semptomların başlangıcı arasında uzun bir latent periyodun (2-8 hafta kadar) olması ile karakterizedir. Bu makalede her iki hastalığın terminolojisi, epidemiyolojisi, etiyolojisi, katkıda bulunan çevresel ve genetik faktörler, altta yatan patolojik mekanizmalar, histolojik ve klinik farklılıkları, ayırıcı tanıya giren hastalıklar, tedavileri ve önlemler anlatılacaktır.

Anahtar Kelimeler: İlaç hipersensitivitesi; makülopapüler ekzantem; DRESS

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