Stevens-Johnson syndrome/TEN induced by lamotrigine in a patient with a cerebral cavernous malformation: a case report


https://doi.org/10.4081/dr.2024.10007
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Authors

  • Chiara Frattini
    chiara.frattini@unifi.it
    Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Alberto Corrà Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Elena Biancamaria Mariotti Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Cristina Aimo Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Valentina Ruffo di Calabria Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Alessandro Magnatta Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Simone Landini Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy. https://orcid.org/0009-0007-5416-4392
  • Lavinia Quintarelli Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Alice Verdelli Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.
  • Marzia Caproni Department of Health Sciences, Section of Dermatology, University of Florence, P. Palagi Hospital, Florence, Italy.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious cutaneous reactions characterized by epidermal and mucocutaneous detachment, most often drug-induced. SJS and TEN are considered the opposite extremes of the same spectrum of disease, where the percentage of skin involvement is <10% in SJS and >30% in TEN; the in-between range is called a SJS/TEN overlap. We present the case of a 64-year-old patient who was treated with lamotrigine, an anti-epileptic drug, and developed SJS/TEN. After being hospitalized and recovering for three days due to the worsening of the clinical presentation, he was transferred to a burn center. Making an early diagnosis and identifying the indicated drug is extremely important to set the appropriate treatment and reduce mortality. Advanced supportive care is required.