PMID: 9184711Jun 1, 1997Paper

Suspected lamotrigine-induced toxic epidermal necrolysis

The Annals of Pharmacotherapy
J J Chaffin, S M Davis

Abstract

To describe a patient who developed toxic epidermal necrolysis (TEN) possibly secondary to lamotrigine use. A 74-year-old white man with a history of probable complex partial seizures was admitted to the neurology service for a prolonged postictal state. His antiepileptic regimen was changed while he was in the hospital to include lamotrigine. After 19 days of hospitalization and 14 days of lamotrigine therapy, the patient became febrile. The next day he developed a rash which progressed within 4 days to TEN, diagnosed by skin biopsy. All suspected drugs were discontinued, including lamotrigine. The patient was treated with hydrotherapy in the burn unit. His symptoms improved and he was discharged from the hospital 26 days after the rash developed. During lamotrigine's premarketing clinical trials, the manufacturer reported several cases of Stevens-Johnson syndrome and TEN. There are several published case reports of lamotrigine-induced severe skin reactions. All of these reports included patients being treated with both valproic acid and lamotrigine. Our patient was exposed to phenytoin, carbamazepine, clindamycin, and lamotrigine, but not valproic acid. The patient reported prior use of phenytoin with no skin rash. Carbamazep...Continue Reading

References

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Citations

Oct 14, 2005·Paediatric Drugs·Arman Danielyan, Robert A Kowatch
Jul 29, 2000·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·I C Wong, S D Lhatoo
Mar 13, 2002·CNS Drugs·Alberto VerrottiFrancesco Chiarelli
Nov 3, 1998·Epilepsia·R G SchliengerN H Shear
Oct 26, 1999·The Annals of Pharmacotherapy·I C WongJ W Sander
Jun 8, 2013·Pharmacological Reports : PR·Barbara BłaszczykWładysław Lasoń
Feb 17, 2001·Journal of Cutaneous Medicine and Surgery·E R EisenN H Shear
Nov 3, 1998·Epilepsia·R G Schlienger, N H Shear

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