Related Experiment Video

Updated: May 15, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
07:22

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Toxic epidermal necrolysis due to lamotrigine in a pediatric patient

Manish J Barvaliya1, Mahendra K Patel, Tejas K Patel

  • 1Department of Pharmacology, Government Medical College, Bhavnagar, India.

Journal of Pharmacology & Pharmacotherapeutics
|January 18, 2013
PubMed

Insights

A 12-year-old boy developed severe toxic epidermal necrolysis (TEN) likely due to lamotrigine, a serious skin reaction. Early detection and vigilance are crucial when using multiple antiepileptic drugs.

Area of Science:

  • Pharmacovigilance
  • Dermatology
  • Neurology

Background:

  • Antiepileptic drug (AED) therapy is common in pediatric patients.
  • Lamotrigine is an AED used as add-on therapy.
  • Concurrent use of AEDs can increase the risk of drug interactions and adverse reactions.

Observation:

  • A 12-year-old male patient on sodium valproate and clonazepam developed toxic epidermal necrolysis (TEN).
  • Lamotrigine was added to his regimen 1-2 months prior to the reaction.
  • The clinical presentation and incubation period were consistent with lamotrigine-induced TEN.

Findings:

  • Lamotrigine was identified as the probable cause of TEN.
  • The combination of lamotrigine with sodium valproate may have increased the risk.
  • Delayed initiation of corticosteroid treatment contributed to the severity of the reaction.

Implications:

  • Healthcare providers must maintain vigilance for serious cutaneous reactions like TEN when prescribing lamotrigine, especially in combination with other AEDs.
  • Awareness of potential drug interactions and the typical incubation period for TEN is critical for early diagnosis and management.
  • Prompt recognition and treatment initiation are essential to improve outcomes in patients experiencing severe adverse drug reactions.

Keywords:
Cutaneous adverse drug reactionlamotriginetoxic epidermal necrolysis

More Related Videos

Drug-Induced Senescence in Liver Cells Promotes M2 Macrophage Polarization: Implications for Tyrosine Kinase Inhibitor-Associated Hepatotoxicity09:32

Drug-Induced Senescence in Liver Cells Promotes M2 Macrophage Polarization: Implications for Tyrosine Kinase Inhibitor-Associated Hepatotoxicity

Published on: October 17, 2025

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...