Journal of

Toxic epidermal necrolysis (TEN) is a server, life-threatening drug-induced mucocutaneous eruption that rarely affects scalp. There has been limited number of cases of TEN arising in patients receiving radiation therapy plus anticonvulsants.Here, we report a case of TEN secondary to anticonvulsant and radiation therapy. An unusual aspect shared by our patient as well as the other reported cases is that the eruption always begins at the site of recent radiation therapy. In this report, we discuss the possible hypotheses for this phenomenon.

Background and Aim: Cutaneous drug reaction is a common side effect of antiepileptic drugs and a frequent cause of treatment discontinuation. These reactions ranges can be a mild maculopapular rash to Stevens-Johnson Syndrom and toxic epidermal necrolysis. Among the traditional anticonvulsant drugs the aromatic compounds Phenytoin, Phenobarbital and Carbamazepin have been associated with relatively higher incidences of cutaneous reactions which can hospitalized the patient. Some of the newer drugs also can induce this problem, especially lamotrigine.
Methods: All records of patiens who were hospitalized at hospitals related to Islamic Azad as well as Rasol Akram hospital with a diagnosis of cutaneous drug reaction to anticonvulsant therapy in 8 years period were reviewed.
Results: The most common culprit was phenytoin (32%) and the least common drug was lamotrigin (3%).
Conclusion: Cutaneous reaction to anticonvulsant drugs is common and sometimes may be life threatening which needs serious treatment options.

Background and Aim: Adverse drug reactions are inevitable outcomes of drug therapy, which may cause mortality and morbidity for those whom are treated in this way. Cutanous adverse drug reactions are abserved in 2% to 3% of inpatients but only 2% of them are considered serious and may cause death. The aim of this study was to determine the cause and clinical forms of adverse drug reactions referred to department of dermatology.

Methods: This cross-sectional study that was done on patients with diagnosis of cutanous adverse drug reactions in 2007 and 2009. All patients suspected with diagnosis of adverse drug reactions were examined by an experienced dermatologist for determination of different kinds of clinical manifestations.

Results: During the study period, 308 patients were recruited. Cutanous adverse drug reactions were found to be more frequent in females (63%) than in males (37%). Betalactam antibiotics were found to be the most frequent cause of adverse cutaneous drug reactions (42.7%), followed by non-steroidal anti-inflammatory drugs (16.5%). Acute urticaria was the most frequent observed drug reaction (59.2%) followed by fixed drug eruption (18.5%) and maculopapular rashes (14.9%).

Conclusion: In this study adverse cutaneous drug reactions was mainly induced by betalactam antibiotics and non-steroidal anti-inflammatory drugs. The most common forms of cutaneous adverse drug reactions were found to be: acute urticaria, fixed drug eruption and maculopapular rashes.