Case Report


Exanthema after lamotrigine use: A clinical case

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1 Department of Neurology – UNIG and Coordinator of the Academic Master's Degree in Neurology at the University of Vassouras, Vassouras – RJ, Brazil

2 School of Medicine – University Iguaçu – UNIG – Nova Iguaçu – RJ, Brazil

3 Iguaçu University – UNIG – Hospital Geral de Nova Iguaçu, Nova Iguaçu – RJ, Brazil

4 Department of Neurology, The Federal University of Rio de Janeiro – UFRJ, Rio de Janeiro, Brazil

5 Department of Medicine – UNIFESP – Paulista School of Medicine, Sao Paulo, Brazil

Address correspondence to:

Antônio Marcos da Silva Catharino

Rua Gavião Peixoto 70, Room 811, CEP 24.2230-100, Icaraí, Niterói – RJ,

Brazil

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Article ID: 101314Z01MO2022

doi: 10.5348/101314Z01MO2022CR

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How to cite this article

Orsini M, Nascimento JF, da Silva Catharino AM, Freitas MRG, de Oliveira AB. Exanthema after lamotrigine use: A clinical case. Int J Case Rep Images 2022;13(1):20–23.

ABSTRACT


Introduction: Lamotrigine is a phenyltriazine compound that inhibits sodium and potassium channels in presynaptic neurons. Maculopapular exanthema is a common side effect of Lamotrigine therapy, occurring most frequently during the first eight weeks of treatment in approximately 3–10% of patients.

Case Report: A 74-year-old female had started Lamotrigine 50 mg due to emotional lability and depression. About 8–9 weeks after the introduction of the drug she presented a rash with exanthema, maculopapular in appearance. The attending physician suggested discontinuation of the medication and reevaluation. Complete regression of the clinical picture occurred. No severe skin rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis were observed.

Conclusion: Lamotrigine is effective for a variety of types of conditions involving neuronal excitability, however, such drug exposes the individual to side reactions ranging from mild skin rashes to even those leading to hospitalization. Measures such as adherence to the manufacturer’s dosing guidelines, titration, and intrinsic characteristics of the individual can minimize this effect.

Keywords: Antiepileptic drugs, Cutaneous rash, Hypersensitivity, Lamotrigine

SUPPORTING INFORMATION


Author Contributions

Marco Orsini - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Jacqueline Fernandes Nascimento - Analysis of data, Drafting the article, Final approval of the version to be published

Antônio Marcos da Silva Catharino - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Marcos RG Freitas - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Acary Bullede Oliveira - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2022 Marco Orsini et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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