EPV862 - Lamotrigine-Induced Toxidermia

EPV862

Lamotrigine-Induced Toxidermia

K. Taleb ^{1 2,*}, F. laajili ³, B. hana ², Z. Bencharfa ³, F. El omari ³

¹psychiatry, Arrazi hospital, ²RAZI HOSPITAL, ³Arrazi hospital, salé, Morocco

 

Introduction: 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