<\/span><\/h2>\nMany drugs can cause cutaneous<\/span> (skin) side effects. The severity of symptoms can range from mild eruption<\/span> to life-threatening conditions that cause skin failure and death. Certain groups of drugs are known to cause frequent, specific or severe skin reactions. Anticonvulsants or antiepileptics are one such group of drugs, some of which have notable side effects on the skin.<\/p>\nIt is important to recognize side effects involving the skin, as prompt withdrawal of the medication may prevent worsening of symptoms caused by the medication. A decision may need to be made in a patient who has undergone a drug eruption<\/span> whether to continue an important drug that might have caused the reaction or switch to an alternative drug.<\/p>\nWhen faced with a new skin rash in a patient, a full drug history is paramount and should include prescription, on the counter<\/span>and alternative medications that the patient is taking so that the medication rashes<\/span> can be considered or discarded.<\/p>\n<\/span>anti-seizure drugs<\/span><\/h2>\nAnti-seizure medications, also known as anti-epileptic or anti-seizure medications, are a diverse group of medications that are commonly used in the treatment of epilepsy and seizures, and less commonly for other conditions such as trigeminal neuralgia<\/span> and bipolar disorder. They work by reducing the excessive firing of neurons<\/span> that happens in a seizure.<\/p>\n\n
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<\/span>Adverse skin reactions<\/span><\/h2>\n\n\nTypes of Skin Reactions to Anticonvulsants<\/caption>\n<\/tbody>\n\n\n| Reaction<\/th>\n | Symptoms<\/th>\n<\/tr>\n |
\n| Morbid<\/span> (similar to measles) drug rash<\/td>\n | \n\n- \nExtended<\/span> or generalized<\/span> pink to red maculopapular<\/span> eruption<\/li>\n
- itching<\/li>\n
- May progress to exfoliative dermatitis<\/span>\/ \/erythroderma<\/span>\n<\/li>\n
- Usually resolves quickly on drug withdrawal<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| \n Drug induced urticaria<\/span> (urticaria)<\/td>\n | \n\n- Transient cure<\/span> with pale centers and red edges<\/li>\n
- Migratory pattern, changing shape and location over several hours.<\/li>\n
- \nAnaphylaxis<\/span> maybe concurrent<\/span> or may occur with subsequent administration of the drug<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Erythema<\/span> multiform<\/td>\n | \n\n- White lesions (iris)<\/li>\n
- Can imply mucous<\/span> membranes<\/li>\n
- Self-limiting and usually resolves without complications<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Stevens-Johnson syndrome<\/span> \/ \/ toxic<\/span> epidermal<\/span> necrolysis (TEN)<\/td>\n | \n\n- It usually develops within the first week of taking the medication.<\/li>\n
- Severe and life-threatening skin reaction with sheet-like skin and mucous membrane<\/span> lost<\/li>\n
- Rare mediated by immune complexes hypersensitivity<\/span>\n<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Anticonvulsant hypersensitivity syndrome\n<\/td>\n | \n\n- Symptoms usually develop 2 to 6 weeks after starting the medication, but can occur at any time<\/li>\n
- Symptoms include the triad of fever<\/span>, generalized maculopapular rash, and lymphadenopathy<\/span>\n<\/li>\n
- The rash spreads to varying degrees over the trunk and extremities.<\/li>\n
- It can affect internal organs such as the kidneys, liver, central nervous system, and bone marrow.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n
<\/span>Cutaneous adverse reaction to anticonvulsants<\/span><\/h5>\n<\/section>\n\n\n \n  \n<\/div>\n morbilliform rash<\/p>\n \n  \n<\/div>\n Urticaria<\/p>\n \n  \n<\/div>\n Erythema multiforme<\/p>\n \n  \n<\/div>\n toxic epidermal necrolysis<\/p>\n \n  \n<\/div>\n purpuric rash<\/p>\n \n  \n<\/div>\n gingival hyperplasia<\/p>\n<\/p><\/div>\n<\/section>\n <\/div>\n \n\nSpecific reactions to anticonvulsant drugs.<\/caption>\n<\/tbody>\n\n\n| Drug<\/th>\n | skin reaction<\/th>\n | Grades<\/th>\n<\/tr>\n | \n| Carbamazepine<\/td>\n | \n\n- Oral ulcers<\/span>\n<\/li>\n
- Urticaria<\/li>\n
- Stevens-Johnson \/ TEN<\/li>\n
- Photosensitivity<\/span><\/li>\n<\/ul>\n<\/td>\n
\n\n- Cutaneous side effects are the most common side effects causing discontinuation of carbamazepine.<\/li>\n
- There is cross reaction between carbamazepine and amitriptyline.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Phenytoin<\/td>\n | \n | | | | | | | |