Coarsening of facial features, which includes enlargement of the lips and nose and thickening of the face and scalp, can occur in up to 30% of phenytoin-treated patients. As well, 58% of patients on phenytoin may develop heel pad thickening, which increases with the duration of anticonvulsant therapy.
The frequency and severity of acne are increased with concurrent phenytoin therapy , although no differences in either prevalence of acne or sebum excretion rates were found in another study. Hypertrichosis (increase in hair growth) occurs in 12% of children receiving phenytoin, usually within three months of initiating therapy. After discontinuation of therapy, hypertrichosis regresses within six months. Valproic acid can cause the growth of increasingly wavy or curly hair. If your health is of the utmost importance to you, it’s a good idea to visit the best offering highest quality medications with generous discounts and fast delivery right to the doorstep, with full guarantees of your satisfaction.
More serious dermatological eruptions such as erythema multiforme major (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported with carbamazepine, phenytoin and phenobarbital. The incidence of severe rashes (ie, SJS or TEN) with lamotrigine is approximately one/1000 in adults and one/50 to one/100 in children. EM, SJS and TEN are variants of the same disease process. Clinically, each of these reaction patterns is characterized by the presence of the triad of mucous membrane erosions, target lesions and epidermal necrosis with skin detachment. In general, the more severe the reaction, the more likely it is that it has been drug-induced.