Phenytoin induced toxic epidermal necrolysis.

Abstract

Toxic Epidermal Necrolysis (TEN) which is characterized by the detachment of the epidermis from the dermis is a rare (1.89/1.000.000 annually) and potentially life-threatening condition. The overall mortality is 20 - 30%. TEN is characterized by sudden apoptosis of keratinocytes leading to mucous membrane erosions and epidermal detachment; detachment of less than 10% of the total body surface area defines Stevens-Johnson Syndrome (SJS); when greater than 30%, it defines TEN, while intermediate cases are called SJS/TEN overlap. Many drugs, including prednisolone, cyclosporin, and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of phenytoin as a prophylactic anticonvulsant after brain surgery, particularly for brain tumors, is a common practice, regardless of whether the patient has a previous history of convulsions. This report described a case of haemorrhagic stroke where phenytoin use induced TEN.

• Authors: Hulya Topcu, Derya Gokcinar, Zeynep Nur Akcaboy, Isil Karabeyoglu, Tuba Unal
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 24 Suppl 3 Pg. S267-9 (Nov 2014) ISSN: 1681-7168 [Electronic] Pakistan
• PMID: 25518798 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticonvulsants
• Carbamazepine
• Phenytoin

Topics

• Anticonvulsants (adverse effects, therapeutic use)
• Carbamazepine (adverse effects, therapeutic use)
• Drug Hypersensitivity (complications)
• Humans
• Male
• Middle Aged
• Phenytoin (adverse effects, therapeutic use)
• Seizures (drug therapy)
• Stevens-Johnson Syndrome (drug therapy, etiology)