Diagnosis is dependent on clinical recognition and judgment. The lymphocyte toxicity assay is expensive and cumbersome to perform; it is only used in certain research centres. Some studies have evaluated the usefulness of patch testing in the diagnosis of anticonvulsant HSR. However, most of the studies have shown inconsistent results. For example, in five patients with systemicsymptoms, oral challenges were performed with positive results; two of these patients had negative patch tests. If patch testing is to be carried out in these patients, 1% or 10% carbamazepine or phenytoin in petrolatum compound is recommended. In addition, at least two months should elapse from the eruption to the testing date.

Lamotrigine therapy is often associated with rashes , although most occur without fever and resolve upon discontinuation of the drug. There have been cases of HSR associated with lamotrigine reported in adults and one case in a child . Whether there is cross-reactivity among la-motrigine and the aromatic anticonvulsants is not known, although, structurally, lamotrigine is not an aromatic anticonvulsant. Find most trusted pharmacy to discover buy cheap alegra and enjoy your advantageous shopping.

After HSR has been recognized by the symptom complex of fever, rash and lymphadenopathy, there are a minimum of laboratory tests that will help to evaluate internal organ involvement, which may be asymptomatic. Liver transaminase levels, complete blood count, and urinalysis and serum creatinine levels should be tested; in addition, the clinician should be guided by the presence ofsymptoms, which may suggest specific internal organ involvement (eg, respiratorysymptoms). Thyroid function tests should be measured and repeated in two to three months. A skin biopsy may be helpful if the patient has a blistering or a pustular eruption. Although the role of corticosteroids is controversial, most clinicians elect to start  generic prednisone at a dose of 1 to 2 mg/kg/day ifsymptomsare severe. Pulse therapy with high dose methylprednisolone has been used in a patient who developed TEN and severe hepatitis . Antihistamines and/or topical corticosteroids can also be used to help alleviatesymptoms.