[Lyell syndrome associated with lamotrigine].
BACKGROUND
Lamotrigine (LTG) is a new antiepileptic of habitual use in monotherapy as much in partial epileptic as in generalised, which presents among other adverse effects: slight rashes and less frequently severe rashes such as Stevens-Johnson syndrome and Lyell syndrome or toxic epidermal necrolysis, above all in combination with valproate (VPA).


METHODS
A 44-yr-old woman in toxico-alcoholic epileptic treatment with VPA, showed a neutropenia possibly of secondary type which it was intended to change to LTG, following an ascending dose of LTG joined to a descending dose of VPA. In the sixth treatment week, the patient developed an erythematous rash which after a week of solar exposure, presented temperature, general discomfort, and in the head, on the front and back part of the thoracic and upper and lower limbs, erythematous lesions with scabbed areas, loosening epidermis areas with a positive Nikolsky sign and severe mucous membrane involvement, being diagnostic of Lyell syndrome. The lesions got slowly better with serum therapy, antibiotherapy, parenteral corticoids and topical treatments.


CONCLUSIONS
There is a probability of severe rash associated with lamotrigine which has to be taken into account, and we advise patients to suppress the medication when they present a minimum rash.
Fernández-Calvo
C
C
Servicio de Medicina Interna, Hospital de Guipúzcoa, San Sebastián, Guipúzcoa, España.
Olascoaga
J
J
Resano
A
A
Urcola
J
J
Tuneu
A
A
Zubizarreta
J
J
D000328:Adult; D000437:Alcoholism / Q000150:complications; D000927:Anticonvulsants / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects; D003863:Depression / Q000150:complications; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000139:chemically induced / Q000209:etiology; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D009503:Neutropenia / Q000139:chemically induced; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology*; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects*; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects
D000927:Anticonvulsants; D000928:Antidepressive Agents; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine
Síndrome de Lyell asociado a lamotrigina.