Psoriasiform eruption induced by anticonvulsants

Area of Science:

• Dermatology
• Pharmacology

Background:

• Antiepileptic drugs (AEDs) are essential for managing seizure disorders.
• While generally safe, some AEDs can cause adverse cutaneous reactions.
• Psoriasiform eruptions are inflammatory skin conditions resembling psoriasis.

Observation:

• Three patients presented with psoriasiform eruptions.
• The eruptions were temporally associated with the use of sodium valproate and carbamazepine.
• In vitro tests, including macrophage migration inhibition (MIF) and rat mast cell degranulation (MCD), supported a causal link.

Findings:

• Sodium valproate and carbamazepine, previously associated with rare cutaneous side effects, are implicated in causing psoriasiform eruptions.
• The causal relationship was supported by clinical observation and in vitro immunological assays.
• This drug-induced psoriasiform eruption may be more prevalent than previously recognized.

Implications:

• AEDs like sodium valproate and carbamazepine should be recognized as potential triggers for psoriasiform eruptions.
• Physicians need to be vigilant for this adverse reaction in patients using these medications.
• Prompt diagnosis and withdrawal of the offending drug are critical for therapeutic resolution.