Dose-related levetiracetam-induced reticulated drug eruption.
Cutaneous drug eruptions are to antiepileptic drugs (AEDs) used for seizure prophylaxis can range from a maculopapular eruption to severe Stevens-Johnson syndrome or toxic epidermal necrolysis. The aromatic drugs: phenytoin, carbamazepine, oxcarbazepine, phenobarbital, primidone, zonisamide and lamotrigine are the most common offenders. In contrast, the second generation AEDs like valproate, topiramate, gabapentin, tiagabine and levetiracetam are rarely associated with a rash. Doses of AEDs are often started low and gradually increased to decrease the risk of allergic reactions. Herein, the authors report a 46-year-old woman with malignant brain tumor, who developed a levetiracetam induced dose-related reticular eruption only after the initial post-operative dose 500 mg twice a day was increased to 1000 mg twice a day, and upon re-challenge when the slower titrated levetiracetam dose reached 750 mg twice a day.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9190, USA.
Tracy C
TC
Beswick
Jack B
JB
Cohen
D000927:Anticonvulsants / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives*
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam