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Toxic Epidermal Necrolysis After Initiation of Felbamate Therapy
Author(s) -
Travaglini Maryann T.,
Morrison Richard C.,
Ackerman Bruce H.,
Haith Linwood R.,
Patton Mary Lou
Publication year - 1995
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1995.tb04363.x
Subject(s) - felbamate , toxic epidermal necrolysis , medicine , anticonvulsant , epilepsy , anesthesia , dermatology , lamotrigine , intensive care medicine , psychiatry
A 33‐year‐old woman with a 13‐year history of partial complex seizures experienced toxic epidermal necrolysis requiring management in a regional burn treatment center after 16 days of single‐agent treatment for epilepsy with felbamate 3600 mg/day. Within 24 hours the target lesions involved 45% of her total body surface area. They coalesced and progressed to exfoliation involving the mucosa and the conjunctiva. The patient was hospitalized for 25 days. Reports in the literature describe life‐threatening rashes after treatment with felbamate in combination with other anticonvulsant agents. We believe this to be the first reported case of felbamate‐induced toxic epidermal necrolysis induced by single‐agent therapy. Although felbamate provides many advantages as an anticonvulsant, its structure can be arranged to a conformation in space similar to that of hydantoins and barbiturates, and thus warrants careful patient monitoring for life‐threatening rashes.