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Updated: Nov 26, 2025

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
Published on: March 14, 2025
Lamotrigine induced toxic epidermal necrolysis: A case report
Kiran Kumar Kc1, Trishant Limbu1, Shirish Shakti Maskay1
1Department of Critical Care Medicine, Grande International Hospital, Kathmandu, Nepal.
Toxic epidermal necrolysis (TEN) is a rare but serious skin reaction that can occur with lamotrigine monotherapy. Early diagnosis and supportive care are crucial for patient recovery.
Area of Science:
- Dermatology
- Pharmacology
- Neurology
Background:
- Antiepileptic drugs (AEDs) can cause severe cutaneous adverse reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
- Lamotrigine, a newer AED, has been associated with adverse effects, though TEN is rare, even at low initial doses.
Observation:
- A case of a 23-year-old postpartum female with complex partial seizures who developed TEN after 14 days of lamotrigine monotherapy is presented.
- The patient experienced a severe reaction requiring intensive care unit (ICU) admission and supportive management, including steroids.
Findings:
- Rapid titration of lamotrigine, especially with valproate, can increase the risk of TEN.
- Factors such as female sex, postpartum status, hormonal influences, and specific genetic markers (HLA-B*1502) may contribute to AED-induced SJS/TEN, particularly in Asian populations.
Implications:
- Prompt diagnosis and withdrawal of lamotrigine, coupled with timely supportive care, are vital for improving outcomes in TEN.
- The SCORTEN score aids in standardizing the assessment of severity and prognosis in TEN patients.
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