Erythema multiforme associated with phenytoin and cranial radiation therapy: A report of three patients and review of the literature

Abstract

The need for prophylactic anticonvulsant therapy especially utilizing phenytoin in patients undergoing cranial radiation therapy should be assessed on a case by case basis. If anticonvulsants are employed, then they must be administered with caution, and all cutaneous reactions developing subsequently within the radiation site must be promptly evaluated with a high index of suspicion for erythema multiforme.

Stevens-Johnson syndrome induced by combined treatment: carbamazepine and cranial radiation therapy. A case of EMDART?

“…W ciągu 2 tygodni stwierdzono całkowite ustąpienie zmian skórno-śluzówkowych. ma Multiforme associated with Phenytoin And Cranial Radiation Therapy [5]. The pathogenesis of the EMPACT syndrome is still unknown.…”

“…Równoczesne leczenie fenytoiną i radioterapią może zakłócać działanie hydrolazy epoksydowej, co osłabia proces detoksyfikacji oksydacyjnych produktów przejściowych. Z kolei produkty przejściowe, wiążąc się z makrocząsteczkami komórkowymi, tworzą hapteny, które mogą wywoływać reakcję immunologiczną i/lub powodować bezpośrednie uszkodzenia komórek [5]. Wysuwano również hipotezę, że wskutek promieniowania może dochodzić do zmniejszenia puli limfocytów T supresorowych.…”

“…Concurrent phenytoin use and radiation therapy may cause dysfunction of epoxide hydrolase, which impairs the detoxification of the oxidative intermediates. These intermediates may bind to cell macromolecules, thereby forming haptens that can induce an immune response and/ or directly damage cells [5]. It has also been hypothesized that radiation may deplete the pool of suppressor T lymphocytes.…”

“…The pathogenesis of skin lesions occurring in association with carbamazepine and radiation theraMultiforme associated with Phenytoin And Cranial Radiation Therapy) [5].…”

A case with Stevens-Johnson syndrome after chemotherapy and radiotherapy

“…[1] Etyolojide ilaçlar, enfeksiyonlar, radyasyon, karsinomlar ve kollajen doku hastalıkları gibi pek çok faktörün rol oynadığı bilinmektedir. [1,2] Ultraviyole ve X-ışınları SJS ve TEN gelişmesinde uyarıcı faktörlerdir. Özellikle intrakraniyal tümörü olanlarda, epilepsi profilaksi ve tedavisi amacıyla fenitoin, karbamazepin ve fenobarbital gibi antiepileptik ilaçların radyoterapi ile birlikte uygulanması sinerjistik etki göstererek SJS/TEN gelişi-mine neden olmaktadır.…”