What two epidermal issues can arise from Tegretol or Lamictal?

• A. Toxic epidermal necrolysis and SJS
• B. Psoriasis and eczema
• C. Acne and dermatitis
• D. Urticaria and angioedema

Answer: (A)

These anticonvulsants can trigger severe, life-threatening skin reactions known as Stevens-Johnson syndrome and toxic epidermal necrolysis. These conditions form a spectrum of immune-mediated damage to the skin and mucous membranes. Stevens-Johnson syndrome involves painful erosions and a rapidly spreading rash with mucosal involvement, while toxic epidermal necrolysis is the more extensive form with widespread skin detachment (the body surface area affected distinguishes TEN from SJS). The risk with lamotrigine is highest in the initial weeks of treatment, especially with faster titration, and carbamazepine also carries SJS/TEN risk, with certain genetic factors increasing susceptibility in some populations. Because these reactions can progress quickly and require intensive care, discontinue the drug at the first sign of a severe rash or mucosal symptoms and seek urgent medical evaluation. Other skin conditions listed are not the classic severe epidermal necrolysis-toxicity reactions linked to these meds.