A progressive and severe rash - answers
McCormack, M McDonagh, C Ali, M
McCormack, M
McDonagh, C
Ali, M
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Affiliation
Walsall Healthcare NHS Trust
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Publication date
2021-04
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Abstract
A 73-year-old female patient with epilepsy presented to hospital with a progressive, diffuse macular rash over the trunk and limbs with associated mucosal blistering and discharge. Ocular symptoms initially predominated and she was treated for presumed bacterial conjunctivitis by her General Practitioner the previous day. On the acute medical unit supportive management was initiated for suspected adverse drug reaction (ADR) to a recent lamotrigine dose increase. Skin biopsy confirmed a diagnosis of toxic epidermal necrolysis. We present this case to highlight the importance of medication history taking and raise awareness of indolent presentations of life-threatening ADRs. Caution should be applied following dose changes to anti-epileptics, even if previously stable.
Citation
McCormack M, McDonagh C, Ali M. A progressive and severe rash - Answers. Acute Med. 2021;20(4):298-301. PMID: 35072390.
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Article