Toxic epidermal necrolysis (TEN) is usually an idiosyncratic, delayed hypersensitivity reaction to a drug.1 Drugs most frequently involved include sulfonamides, antibiotics, allopurinol, anti-inflammatory agents, and anticonvulsant agents.2 Lamotrigine is a new antiepileptic drug of the triazine family.3 Its potential to cause mucocutaneous reactions, which occur early in 3% to 10% of patients, is well-known.4 In some patients, severe skin reactions including Stevens-Johnson syndrome and TEN may occur within 8 weeks of starting lamotrigine treatment.5 The combination of anticonvulsants may increase the risk of such reactions.
Mansouri P, Rabiei M, Pourpak Z, Hallaji Z. Toxic Epidermal Necrolysis Associated With Concomitant Use of Lamotrigine and Carbamazepine: A Case Report. Arch Dermatol. 2005;141(6):788-803. doi:10.1001/archderm.141.6.788