Generalized pustulation as a manifestation of the anticonvulsant hypersensitivity syndrome

Kleier, R. S.

doi:10.1001/archderm.127.9.1361

Cited by 38 publications

(33 citation statements)

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“…As eosinophil accumulation is also thought to account for the internal organ involvement seen in DRESS syndrome, they might have a role in its management. Dramatic improvement in clinical symptoms and laboratory findings has been observed soon after corticotherapy in many independent case reports [16, 17, 18, 19]. Relapses have also been described after tapering or withdrawal of systemic steroids [19], which further suggests their therapeutic role in patients with DRESS syndrome.…”

Section: Systemic Corticosteroidsmentioning

confidence: 99%

Management of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome): An Update

2003

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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rather distinct severe adverse drug reaction characterised by skin rash, fever, lymph node enlargement and internal organ involvement. Our aim was to review the available data regarding the management of this probably underrecognised subset of drug reaction. So far, the only undisputed way to treat severe hypersensitivity reactions is prompt withdrawal of the offending drug. The use of systemic corticosteroids remains controversial. The benefit of therapies aimed at accelerating the elimination of the causative drug deserves further studies. In the absence of a well-established therapy, primary and secondary prevention have a key role in the management of DRESS syndrome.

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Section: Systemic Corticosteroidsmentioning

confidence: 99%

Management of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome): An Update

2003

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“…It is associated with atypical lymphocytosis in some cases. The cutaneous eruption is frequently morbilliform, may evolve into erythroderma, and vesiculation and pustulation [2] can develop. We present a case of carbamazepine-induced hypersensitivity syndrome occurring in an apparently photodistributed pattern which has not previously been described.…”

Section: Introductionmentioning

confidence: 99%

Carbamazepine-Induced Hypersensitivity Syndrome Occurring in a Photodistributed Pattern

Edwards²,

Ibbotson³

2006

Dermatology

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A 76- year- old man was commenced on carbamazepine for partial seizures. This was followed by the development of a rash in an apparently photodistributed pattern, fever, lymphadenopathy, eosinophilia, abnormal liver function tests and atypical lymphocytosis fulfilling the criteria for drug-induced hypersensitivity syndrome. Discontinuation of carbamazepine and application of topical steroid resulted in clearance of the rash, normalization of liver function tests and improvement in eosinophilia. The photodistributed pattern in this case of carbamazepine-induced hypersensitivity syndrome is of interest.

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“…The boy also developed allergic dermatitis. This side-effect, frequently reported with other antiepileptic drugs, seems to be exceptional to VPA [6,7,9].…”

Section: Discussionmentioning

confidence: 68%

Haematological disturbances during long-term valproate therapy

Brichard¹,

Vermylen²,

Scheiff³

et al. 1994

Eur J Pediatr

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A 14-year-old boy with mental retardation presented with severe thrombocytopenia, macrocytic anaemia and allergic dermatitis. He had been treated with valproate for seizures since the age of 2 years. Clinical examination showed severe purpura, mucous bleeding and extensive dermatitis. Tests to detect serum direct antiplatelet antibodies were positive and bone marrow examination revealed myelodysplastic abnormalities. Valproate was discontinued and both dermatitis and general condition of the child improved with normalization of the full blood count. This report suggests that valproate may produce both peripheral immune thrombocytopenia and severe bone marrow depression several years after the initiation of the therapy.

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Generalized pustulation as a manifestation of the anticonvulsant hypersensitivity syndrome

Cited by 38 publications

References 0 publications

Management of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome): An Update

Management of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS Syndrome): An Update

Carbamazepine-Induced Hypersensitivity Syndrome Occurring in a Photodistributed Pattern

Haematological disturbances during long-term valproate therapy

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