December 2012, Volume 62, Issue 12

Letter to the Editor

Anticonvulsants, dermal complications

Madam, Epilepsy is one of the prevalent neurological diseases treated with several drugs especially anticonvulsants.1 Although other treating effects have been mentioned for this group of drugs, they are variously used in treating neurological, dermal and other, diseases.2 Considering ever-increasing use of the mentioned drugs in society, it is better to consider their complications especially dermal ones which are sometimes deathly.3 Anticonvulsants are of main elements in controlling and preventing from epileptic seizures.4 Different kinds of anticonvulsants are used considering relatively high prevalence of convulsion in Iran (about 1%). However, this group of drugs is used to treat other diseases such as neuralgia following herpes zoster which are very effective in pain mitigation.5 Although most systemic complications of the mentioned drugs such as hepatitis and renal insufficiency are more considered, it is better to remember that most of them result in very severe mucocutaneous complications such that the drugs should be changed or their consumption should be stopped.6 Since anticonvulsants lead to a lot of dermal complications such as rash, hypersensitivity syndrome, alopecia, pseudolymphomatous lesions, gingival hyperplasia, erythema multiforme, acneiform eruptions, Vasculitis, Drug lupus, and Stevens-Johnson syndrome.7,8 Prescribing the drugs considering complete information of its kind and methods of treating the mentioned complications is recommended in order to prevent disability or even mortality.
 
Hamideh Herizchi Qadim,1 Mohamad Goldust2
Department of Dermatology,1 Medical Student, Student Research Committee,2 Tabriz University of Medical Science, Iran.
Corresponding Author: Mohamad Goldust.
Email: drmgoldust@yahoo.com

Reference

1. Voronkova KV, Pylaeva OA, Kholin AA, Kosiakova ES, Mazal\\\'skaia OV, Koroleva N, et al. [Side-effects of antiepileptic treatment: the current state of the problem]. Zh Nevrol Psikhiatr Im S S Korsakova 2011; 111: 44-51.
2. Roquin G, Peres M, Lerolle N, Dib N, Mercat A, Croue A, et al. First report of lamotrigine-induced drug rash with eosinophilia and systemic symptoms syndrome with pancreatitis. Ann Pharmacother 2010; 44: 1998-2000.
3. Natkunarajah J, Atherton D, Elmslie F, Mansour S, Mortimer P. Treatment with carbamazepine and gabapentin of a patient with primary erythermalgia (erythromelalgia) identified to have a mutation in the SCN9A gene, encoding a voltage-gated sodium channel. Clin Exp Dermatol 2009; 34: e640-2.
4. Lkhagvasuren B, Nakamura Y, Oka T, Sudo N, Nakamura K. Social defeat stress induces hyperthermia through activation of thermoregulatory sympathetic premotor neurons in the medullary raphe region. Eur J Neurosci 2011; 34: 1442-52.
5. Nouri-Merchaoui S, Mahdhaoui N, Methlouthi J, Zakhama R, Seboui H. [Neonatal seizures revealing incontinentia pigmenti]. Arch Pediatr 2011; 18: 1095-9.
6. Fidan E, Fidan M, Ozdemir F, Kavgaci H, Aydin F. Phenytoin- and cranial radiotherapy-induced toxic epidermal necrolysis treated with combination therapy: systemic steroid and intravenous immunoglobulin. Med Oncol 2012; 29: 686-9.
7. Wetter DA, Camilleri MJ. Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. Mayo Clin Proc 2010; 85: 131-8.
8. Kara NN. Spinal congenital dermal sinus associated with upper thoracic meningocele. Case Report. Neurosurg Focus. 2003; 15: ECP2.

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