Psychoactive drugs and skin

Late-onset Anticonvulsant Hypersensitivity Syndrome Mimicking Lymphoma

“…Skin lesions are observed in 90% of affected patients, including facial edema, erythema multiforme, Stevens-Johnson syndrome, common morbilliform lesions, erythroderma and oral lesions (1). The most commonly involved internal organ is the liver, associated with hepatitis, although nephritis, pneumonitis and pancreatitis can also occur.…”

“…AHS is a life-threatening, idiosyncratic drug reaction that is associated with aromatic antiepileptic drugs, such as carbamazepine, phenobarbital and phenytoin, as well as new-generation drugs, such as lamotrigine. Its pathophysiology is not understood completely, although a genetic predisposition related to certain enzyme deficits, lymphocyte activation, herpes virus activation and specific human leukocyte antigen (HLA) alleles might be responsible for its pathogenesis (1). This cutaneous drug reaction is also called pseudolymphoma because of its clinical and histological similarities with malignant lymphoma (2).…”

Bupropion-induced angioedema

“…8,15 Bupropion also inhibits uptake of serotonin and has moderate anticholinergic activity. In the product labeling, angioedema is documented as a possible, but rare, ADR, occurring at a rate of 0.1-0.3%, with symptoms usually developing between 10 and 20 days after initiation of the drug.…”

Erythema multiforme-like eruption from a slimming drug preparation cutaneous adverse drug reaction

“…Given the absence of target lesions, a skin biopsy of a shoulder lesion was also carried out. Histopathological findings of an inflammatory pattern characterized by high-density lichenoid infiltrate rich in T cells, lymphocytes at the dermoepidermal junction, satellite cell necrosis, vacuolar degeneration of the basal layer, and dermal edema were suggestive of an EM-type drug eruption[1–3] [Figure 4]. …”

“…Approximately half the cases are idiopathic. [1–3] Most commonly involved drugs include anticonvulsants, phenothiazines, nonsteroidal anti-inflammatory drugs, penicillins, and sulfonamides. [1–4] EM minor presents with mildly itchy, erythematous, expanding macules or papules that may coalesce and become generalized.…”