The pathogenesis of these severe cutaneous adverse drug reactions (ADRs) is unknown, although a metabolic basis has been hypothesized . Sulphonamides and aromatic anticonvulsants (ie, phenobarbital, phenytoin, carbamazepine), which are the two groups most frequently associated with SJS and TEN, are metabolized to toxic metabolites, which are subsequently detoxified in most individuals. However, in predisposed patients with a genetic defect, the metabolite may bind covalently to proteins. In some patients, the metabolite-protein adducts may trigger an immune response, which may lead to a cutaneous ADR.

Treatment of EM, SJS and TEN includes discontinuation of a suspected drug and supportive measures, such as careful wound care, hydration and nutritional support . Because it is unknown whether a patient will develop a serious derma-tological eruption or simply a benign rash, discontinuation of lamotrigine is recommended in any patient who develops a rash, unless it is clearly not drug-related. The use of corticosteroids in SJS and TEN is controversial. Some clinicians believe that corticosteroids may be beneficial when administered early in the disease and at a relatively high dosage . However, other authors suggest that corticosteroids do not shorten the recovery time and may increase the risk of complications, including secondary infections and gastrointestinal bleeding . Patients who have developed a severe cutaneous adverse reaction (ie, EM, SJS and TEN) should not be rechallenged with the drug nor undergo desensitization with the medication. Please make sure you read all the information provided above to choose the right medications at the to benefit the most from the treatment. At this pharmacy, you will find tons of cheap and efficient meds for any problem.

Other types of skin eruptions include lichenoid eruption , necrotizing vasculitis , exfoliative dermatitis and pustular drug eruption with carbamazepine and other anticonvulsants . Numerous other cutaneous reactions have been reported with all of the anticonvulsants, including alopecia (especially with valproic acid) , hirsutism, fixed drug eruption and photosensitivity (especially with carba-mazepine).