title: Fixed Drug Eruption in an Epileptic Patient Previously Receiving Treatment With Phenytoin for Seven Years.
abstract: A 52-year-old African American female presented with severe left thigh pain of unknown etiology. She had a past medical history of generalized seizure disorder treated with phenytoin for 7 years without incident. During admission a nurse witnessed a seizure, and consequently loading and maintenance doses of phenytoin were administered to obtain a therapeutic serum concentration. The patient had a history of noncompliance with multiple subtherapeutic phenytoin levels. Subsequently, unifocal blue discolored spots appeared, progressing to a bullous component that was positive for skin sloughing. Drug-induced fixed drug eruption was diagnosed and attributed to phenytoin. Clinicians should be cognizant of drug-induced fixed drug eruption in patients just initiated and those receiving long-term treatment with phenytoin. The administration rate of phenytoin may be associated with the development of fixed drug eruption.
authors.affiliation: University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
authors.forename: Keaton S
authors.initials: KS
authors.lastname: Smetana
authors.affiliation: University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Suda
authors.affiliation: University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Hamilton
keywords: administration rate; adverse drug reaction; fixed drug eruption; phenytoin