title: Phenytoin induced toxic epidermal necrolysis.
abstract: Toxic Epidermal Necrolysis (TEN) which is characterized by the detachment of the epidermis from the dermis is a rare (1.89/1.000.000 annually) and potentially life-threatening condition. The overall mortality is 20 - 30%. TEN is characterized by sudden apoptosis of keratinocytes leading to mucous membrane erosions and epidermal detachment; detachment of less than 10% of the total body surface area defines Stevens-Johnson Syndrome (SJS); when greater than 30%, it defines TEN, while intermediate cases are called SJS/TEN overlap. Many drugs, including prednisolone, cyclosporin, and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of phenytoin as a prophylactic anticonvulsant after brain surgery, particularly for brain tumors, is a common practice, regardless of whether the patient has a previous history of convulsions. This report described a case of haemorrhagic stroke where phenytoin use induced TEN.
authors.affiliation: Department of Anesthesiology and Reanimation, Tokat Turhal State Hospital, Tokat, Turkey.
authors.forename: Hulya
authors.initials: H
authors.lastname: Topcu
authors.affiliation: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Gokcinar
authors.affiliation: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Zeynep Nur
authors.initials: ZN
authors.lastname: Akcaboy
authors.affiliation: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Isil
authors.initials: I
authors.lastname: Karabeyoglu
authors.affiliation: Department of Pathology, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Tuba
authors.initials: T
authors.lastname: Unal
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects* / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy*; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D010672:Phenytoin