Carbamazepine
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Carbamazepine Exfoliathe dermatitis Dermatologic reactions are known to occur in about 3 % of the patients treated with carbamazepine. A 12-year-old girl with a 9 year history of partial complex seizures controlled effectively with phenytoin. phenobarbitone. and diazepam. developed a [ash covering her entire body 1 month after changing the original treatment to carbamazepine (2DOmg bid), A diagnosis of Lyell's disease was made on a skin culture positive for SlaphylococclIs aureus and dicloxaclllin (250mg qid) was prescribed, but her condition continued to worsen. On admission. exfoliative dermatitis with some area<; of crusting and exudation was found spread over the entire surface of her body, involving the conjunctival mucous membranes. Carbamazepine was discontinued and IV oxacillin was given 4 hourly along with hydrocortisone (6Dmg qid) and 0.9 % sodium chloride IV. O. I % triamcinoline acetonide cream was applied on the body tid immediately after tepid water baths. As the conjunctival cultures were positive for Sfapl1yfococccls aw(!us and Pseudomonas aerllginosa. an ophthalmic ointment consisting of neomycin sulphate and polymyxin B sulphate was also used. On the Jrd hospital due to substantial peeling, all previous medications were discontinued and replaced with prednisone ( ISmg qidl and dicloxacillin (250mg qidl. Six days later the patient was discharged on prednisone for I more week (subsequently tapered). Dermatitis had resolved except for a few small fissures on her soles. The exact aetiology of exfoliative dermatitis is unknown. It is thought to be associated with preexisting dermatologic disorders or drug Reed. M D. e! al., Chnical Pt>armacy I, n {No I. I q82) 0157-7271/82/0423-0003(0$01.00/0 © ADISPress Reactions 23 Apr 1 982 3
Transcript of Carbamazepine
Carbamazepine
Exfoliathe dermatitis Dermatologic reactions are known to occur in about 3 % of the patients treated with carbamazepine. A 12-year-old girl with a 9 year history of partial complex seizures controlled effectively with phenytoin. phenobarbitone. and diazepam. developed a [ash covering her entire body 1 month after changing the original treatment to carbamazepine (2DOmg bid), A diagnosis of
Lyell's disease was made on a skin culture positive for SlaphylococclIs aureus and dicloxaclllin (250mg qid) was prescribed, but her condition continued to worsen. On admission. exfoliative dermatitis with some area<; of crusting and exudation was found spread over the entire surface of her body, involving the conjunctival mucous membranes. Carbamazepine was discontinued and IV oxacillin was given 4 hourly along with hydrocortisone (6Dmg qid) and 0.9 % sodium chloride IV. O. I % triamcinoline acetonide cream was applied on the body tid immediately after tepid water baths. As the conjunctival cultures were positive for Sfapl1yfococccls aw(!us and Pseudomonas aerllginosa. an ophthalmic ointment consisting of neomycin sulphate and polymyxin B sulphate was also used. On the Jrd hospital da~' due to substantial peeling, all previous medications were discontinued and replaced with prednisone ( ISmg qidl and dicloxacillin (250mg qidl. Six days later the patient was discharged on prednisone for I more week (subsequently tapered). Dermatitis had resolved except for a few small fissures on her soles. The exact aetiology of exfoliative dermatitis is unknown. It is thought to be associated with preexisting dermatologic disorders or drug admini~tration. Reed. M D. e! al., Chnical Pt>armacy I, n {No I. I q82)
0157-7271/82/0423-0003(0$01.00/0 © ADISPress Reactions 23 Apr 1 982 3
