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Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid

Anti-epileptic drugs can be associated with a wide spectrum of cutaneous adverse reactions ranging from simple maculopapular rashes to more severe and life threatening reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis. These rashes are well documented with older antiepileptic dr...

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Detalles Bibliográficos
Autores principales: Kaur, Sukhjot, Dogra, Alka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778793/
https://www.ncbi.nlm.nih.gov/pubmed/24082198
http://dx.doi.org/10.4103/0019-5154.117319
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author Kaur, Sukhjot
Dogra, Alka
author_facet Kaur, Sukhjot
Dogra, Alka
author_sort Kaur, Sukhjot
collection PubMed
description Anti-epileptic drugs can be associated with a wide spectrum of cutaneous adverse reactions ranging from simple maculopapular rashes to more severe and life threatening reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis. These rashes are well documented with older antiepileptic drugs like phenytoin, phenobarbitone and carbamazapine. Lamotrigine is a newer, unrelated antiepileptic drug that causes skin rashes in 3-10% of new users. Higher starting dose or rapid escalation, concurrent treatment with valproic acid, and a previous history of a rash with other antiepileptic drugs are well recognized risk factors for lamotrigine related serious rashes. We report two patients with toxic epidermal necrolysis, resulting from concomitant use of lamotrigine and valproic acid. It is emphasized that clinicians adhere to the recommended dosage guidelines and adopt a slow dose titration when initiating treatment with lamotrigine.
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spelling pubmed-37787932013-09-30 Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid Kaur, Sukhjot Dogra, Alka Indian J Dermatol E-Case Report Anti-epileptic drugs can be associated with a wide spectrum of cutaneous adverse reactions ranging from simple maculopapular rashes to more severe and life threatening reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis. These rashes are well documented with older antiepileptic drugs like phenytoin, phenobarbitone and carbamazapine. Lamotrigine is a newer, unrelated antiepileptic drug that causes skin rashes in 3-10% of new users. Higher starting dose or rapid escalation, concurrent treatment with valproic acid, and a previous history of a rash with other antiepileptic drugs are well recognized risk factors for lamotrigine related serious rashes. We report two patients with toxic epidermal necrolysis, resulting from concomitant use of lamotrigine and valproic acid. It is emphasized that clinicians adhere to the recommended dosage guidelines and adopt a slow dose titration when initiating treatment with lamotrigine. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3778793/ /pubmed/24082198 http://dx.doi.org/10.4103/0019-5154.117319 Text en Copyright: © Indian Journal of Dermatology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle E-Case Report
Kaur, Sukhjot
Dogra, Alka
Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title_full Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title_fullStr Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title_full_unstemmed Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title_short Toxic Epidermal Necrolysis Due to Concomitant Use of Lamotrigine and Valproic Acid
title_sort toxic epidermal necrolysis due to concomitant use of lamotrigine and valproic acid
topic E-Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778793/
https://www.ncbi.nlm.nih.gov/pubmed/24082198
http://dx.doi.org/10.4103/0019-5154.117319
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