[Hypersensitivity syndrome caused by phenytoins and phenobarbital]

Recently we have seen three patients with a clinically characteristic hypersensitivity reaction to phenytoin two to four weeks after they started these therapy. The picture simulated a severe infectious exanthem; it was characterized by a generalized erythematous macular eruption, massive edema of the face, fever, generalized lymphadenopathy and hepatic involvement. The laboratory findings revealed leukocytosis with atypical lymphocytes, eosinophilia and altered liver function. Involution of the eruption was characterized by exfoliation similar to that observed in scarlet fever. There was prompt and good response to treatment with systemic steroids.