Lamotrigine-Induced Toxidermia
K. Taleb, F. Laajili, B. Hana, Z. Bencharfa, F. El OmariIntroduction
Lamotrigine, widely used in bipolar and depressive disorders, may rarely cause severe cutaneous adverse reactions such as DRESS syndrome. Early recognition is crucial to prevent severe complications.
Objectives
To report a case of lamotrigine-induced DRESS syndrome and emphasize the importance of early detection and careful monitoring to prevent severe complications.
Methods
Case Report: A 19-year-old female treated for recurrent depressive disorder was started on lamotrigine (50 mg/day). Six weeks later, she developed a diffuse pruritic maculopapular rash, fever (38.5°C), cervical lymphadenopathy, and fatigue.
Laboratory tests showed eosinophilia (1200/μL) and moderate hepatic cytolysis (AST 85 U/L, ALT 92 U/L).
The RegiSCAR score suggested probable DRESS. Lamotrigine was promptly discontinued, and systemic corticosteroids were introduced, leading to rapid improvement and resolution of skin lesions within 10 days.
Results
Discussion DRESS is a rare but potentially fatal drug-induced reaction, typically occurring 2–8 weeks after exposure. The risk increases with rapid dose escalation or valproate co-administration.
Management includes immediate drug withdrawal, symptomatic treatment, and systemic corticosteroids in severe cases.
Conclusions
Ce cas souligne la nécessité d’une surveillance étroite lors de l’instauration du traitement par lamotrigine.
Tout signe d’alerte cutané ou systémique doit inciter à une évaluation urgente afin de prévenir les complications graves liées au syndrome DRESS.
Disclosure of Interest
None Declared