Phenytoin induced toxic epidermal necrolysis

J Coll Physicians Surg Pak. 2014 Nov:24 Suppl 3:S267-9.

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.

Publication types

  • Case Reports

MeSH terms

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

Substances

  • Anticonvulsants
  • Carbamazepine
  • Phenytoin