Stevens-Johnson syndrome (SJS) is a rare but life-threatening acute mucocutaneous
hypersensitivity reaction, usually related to drugs. Severe cutaneous adverse effects such as SJS and
toxic epidermal necrolysis can arise during treatment with
antiepileptic drugs (AEDs). A 23-year-old female patient with idiopathic
epilepsy was referred to the emergency service with
fever, oral and genital mucosal lesions, generalized
rash, and weakness. She had been taking
carbamazepine,
valproic acid, and
lamotrigine until 1 week prior to referral. Following consultations with a range of clinicians, the patient was diagnosed with SJS related to
lamotrigine on the basis of her history and physical findings, and on consideration of current consensus definitions of this condition. The patient was followed up and treated in the emergency intensive care unit with intravenous fluids, antibacterial
therapy, and
methylprednisolone. After 18 days, the patient was considered to have made a sufficient recovery and was discharged. Patients who undergo
therapy with AEDs, particularly new users of these agents, should be informed of and monitored for possible systemic and cutaneous adverse effects of AEDs. Polytherapy should be avoided for as long as possible as this increases the frequency of adverse effects, and treatment should be discontinued if any
rash appears.