Carbamazepine-induced pseudolymphoma with CD-30 positive cells.
A 44-year-old woman known to be allergic to phenytoin was treated with carbamazepine for 1 month and developed fever, lymphadenopathy, pneumonitis, hepatitis, and a morbilliform eruption. A skin biopsy specimen showed atypical lymphocytes in the dermis that were CD-3+, CD-30+, and L26-. T-cell gene rearrangement studies were negative. A diagnosis of anticonvulsant hypersensitivity syndrome with histologic features of a pseudolymphoma was made and her illness quickly improved after carbamazepine was discontinued. This case was typical of the anticonvulsant hypersensitivity syndrome and demonstrated cross-reactivity among the aromatic anticonvulsants. However, to our knowledge, this represents the first report of a carbamazepine-induced hypersensitivity with histologic features of a cutaneous pseudolymphoma, including CD-30+ cells.
Nathan
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DL
Division of Dermatology, University of Kansas Medical Center, Kansas City 66160, USA.
Belsito
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DV
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D018951:Antigens, CD20 / Q000032:analysis; D001706:Biopsy; D017252:CD3 Complex / Q000032:analysis; D002220:Carbamazepine / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D003429:Cross Reactions; D003875:Drug Eruptions / Q000209:etiology; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D005334:Fever / Q000139:chemically induced; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D017730:Ki-1 Antigen / Q000032:analysis*; D008214:Lymphocytes / Q000473:pathology; D011014:Pneumonia / Q000139:chemically induced; D019310:Pseudolymphoma / Q000139:chemically induced* / Q000473:pathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology; D013577:Syndrome
D000927:Anticonvulsants; D018951:Antigens, CD20; D017252:CD3 Complex; D017730:Ki-1 Antigen; D002220:Carbamazepine