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Cutaneous and immunologic reactions to phenytoin
A K Silverman1, J Fairley, R C Wong
1University of Rochester School of Medicine, NY.
Journal of the American Academy of Dermatology
|April 1, 1988
Summary
Phenytoin, a key anticonvulsant, effectively treats epilepsy and has expanded dermatological uses. While generally safe, it can cause various cutaneous and immunologic reactions, including hypersensitivity and potential lymphoma links.
Area of Science:
- Pharmacology
- Dermatology
- Neurology
Background:
- Phenytoin (diphenylhydantoin) is a long-established anticonvulsant and antiarrhythmic.
- Its use dates back to 1938, primarily for epilepsy management.
- Recent dermatological applications include epidermolysis bullosa, scleroderma, and pachyonychia congenita.
Purpose of the Study:
- To comprehensively review and analyze therapeutic and toxic reactions to phenytoin.
- To summarize the known side effects, allergic effects, and idiosyncratic effects of phenytoin.
- To provide an overview of phenytoin's broad spectrum of cutaneous and immunologic reactions.
Main Methods:
- Literature review and synthesis of reported cases and studies on phenytoin.
- Analysis of therapeutic efficacy and adverse event profiles.
- Categorization of reactions into side effects, allergic effects, and idiosyncratic effects.
Main Results:
- Phenytoin remains invaluable for epilepsy treatment.
- Dermatological indications have expanded.
- Despite widespread use, complication frequency is relatively low.
- Reported reactions include tissue proliferative syndromes, drug hypersensitivity, and a potential link to lymphoma.
Conclusions:
- Phenytoin is a versatile medication with established efficacy.
- While generally well-tolerated, a range of adverse reactions can occur.
- Understanding these reactions is crucial for safe and effective patient management.