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Cutaneous (Skin) Adverse Reactions to AED

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Cutaneous drug reactions (CDRs) to anticonvulsants are relatively uncommon. These reactions are idiosyncratic and  there are several problems in classifying and reporting CDRs.

It is therefore make it difficult to determine their true incidence and causality:
Exanthematous (morbilliform) reactions are the most common.

Most CDRs are mild, but severe and life-threatening reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and anticonvulsant hypersensitivity syndrome can also occur.

Management of anticonvulsant-related CDRs generally includes withdrawal of the causative drug and symptomatic therapy as required. ([i])

CDRs to gabapentin, topiramate and tiagabine have not been reported in medical literature to date.

Below is a Table depicting the various types of reaction that may occur, mild reactions at the top, more severe towards the bottom of the table.



[i] Ruble R, Matsuo F. CNS Drugs 1999; 12 (3): 215-236 Anticonvulsant-induced cutaneous reactions: incidence, mechanisms and management.