2017 Volume 11 Issue 4 Pages 322-325
A 49-year-old man had been treated for bipolar disorder. He exhibited a high fever and severe oral mucosal erosion with dysphagia three weeks after lamotrigine administration. He was referred to our department for evaluation. A skin biopsy specimen taken from a papule on his trunk revealed necrotic keratinocytes in the epidermis, and infiltration of lymphocytes and neutrophils into the interface. The lymphocyte stimulation test (LST) was positive with lamotrigine. Based on the clinical course and laboratory examination, we diagnosed his skin eruption as Stevens-Johnson syndrome caused by lamotrigine. After daily administration of prednisolone at 60 mg and discontinuation of lamotrigine, his eruption markedly improved. There have been many case reports on severe cutaneous adverse reactions induced by lamotrigine. Compared with other reports, our patient had an unusual clinical manifestation in which severe oral membrane erosion preceded the development of erythema and papules on the trunk and extremities.
