Información de la revista
Vol. 98. Núm. 7.
Páginas 483-485 (septiembre 2007)
Vol. 98. Núm. 7.
Páginas 483-485 (septiembre 2007)
Case reports
Acceso a texto completo
Toxic Epidermal Necrolysis Induced by Phenytoin and Whole Brain Radiotherapy
Necrolisis Epidérmica Tóxica Inducida por Fenitoína y Radioterapia Holocraneal
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F.A. Fernándeza, E. Pintorb,
Autor para correspondencia
emilio.pintor@uem.es

Correspondence: Departamento de Especialidades Médicas Aplicadas. Facultad de Ciencias de la Salud. Universidad Europea de Madrid. Tajo, s/n. Villaviciosa de Odón. Madrid. Spain.
, R. Quesadaa, F.J. Garcésa
a Servicio de Medicina Interna, Hospital La Moraleja-Sanitas, Alcobendas, Madrid, Spain
b Departamento de Especialidades Médicas Aplicadas, Universidad Europea de Madrid, Spain
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Abstract

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) have been associated with some drugs, particularly anticonvulsants such as phenytoin. Some authors have pointed out an increased risk of TEN/SJS when phenytoin is associated with whole brain radiotherapy. We report a patient diagnosed with breast adenocarcinoma and brain metastases that was on treatment with phenytoin and, shortly after receiving whole brain radiotherapy, developed toxic epidermal necrolysis.

Key words:
phenytoin
whole brain radiotherapy
toxic epidermal necrolysis
Stevens-Johnson syndrome
anticonvulsants
Resumen

Los cuadros de necrolisis epidérmica tóxica (NET)-síndrome de Stevens-Johnson (SSJ) se han asociado al consumo de algunos fármacos, en especial a la toma de antiepilépticos como fenitoína. Algunos autores han planteado un incremento en el riesgo de padecer NET/SSJ cuando la fenitoína se asocia con radioterapia craneal. Se presenta el caso de una paciente diagnosticada de adenocarcinoma de mama con metástasis cerebrales en tratamiento con fenitoína que poco después de recibir radioterapia cerebral presenta un cuadro de NET.

Palabras clave:
fenitoína
radioterapia holocraneal
necrolisis epidermica tóxica
síndrome de Stevens-Johnson
antiepilépticos
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References
[1.]
J.C. Roujeau, R.S. Stern.
Severe adverse cutaneous reactions to drugs.
N Engl J Med, 331 (1994), pp. 1272-1285
[2.]
J.C. Roujeau, J.P. Kelly, L. Naldi, B. Rzany, R.S. Stern, T. Anderson, et al.
Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis.
N Engl J Med, 333 (1995), pp. 1600-1607
[3.]
B. Rzany, O. Correia, J.P. Kelly, L. Naldi, A. Auquier, R. Stern.
Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis during first weeks of antiepileptic therapy: a case-control study. Study Group of the International Case Control Study on Severe Cutaneous Adverse Reactions.
Lancet, 353 (1999), pp. 2190-2194
[4.]
M. Mockenhaupt, J. Messenheimer, P. Tennis, J. Schlingmann.
Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptics.
[5.]
N. Scheinfeld.
Phenytoin in cutaneous medicine: its uses, mechanisms and side effects.
Dermatol Online J, 9 (2003), pp. 6
[6.]
J.D. Fein, K.L. Hamann.
Images in clinical medicine. Stevens-Johnson syndrome.
N Engl J Med, 352 (2005), pp. 1696
[7.]
K. Devi, S. George, S. Criton, V. Suja, P.K. Sridevi.
Carbamazepine – the commonest cause of toxic epidermal necrolysis and Stevens-Johnson syndrome: a study of 7 years.
Indian J Dermatol Venereol Leprol, 71 (2005), pp. 325-328
[8.]
J.Y. Delattre, B. Safai, J.B. Posner.
Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin.
Neurology, 38 (1988), pp. 194-198
[9.]
M.S. Gómez-Criado, I. Ayani, T. León-Colombo, M.L. Ramos, M.J. Reneses.
Síndrome de Stevens-Johnson, necrolisis epidérmica tóxica y fenitoína. Factores asociados a un aumento del riesgo.
Rev Neurol, 38 (2004), pp. 1056-1060
[10.]
Y.M. Khafaga, A. Jamshed, A.A. Allam, W.A. Mourad, A. Ezzat, A. Al Eisa, et al.
Stevens-Johnson syndrome in patients on phenytoin and cranial radiotherapy.
Acta Oncol, 38 (1999), pp. 111-116
[11.]
Y. Eralp, A. Aydiner, F. Tas, P. Saip, E. Topuz.
Stevens-Johnson syndrome in a patient receiving anticonvulsant therapy during cranial irradiation.
Am J Clin Oncol, 24 (2001), pp. 347-350
[12.]
C. Pérez-Hortez, D. García-Almagro, S. Urrutia, C. Schoendorf, O. López-Barrantes.
Dos casos de necrolisis epidérmica tóxica localizada asociada a radioterapia.
Actas Dermosifiliogr, 94 (2003), pp. 475-478
[13.]
F. Oner Dincbas, S. Yoruk, C. Demirkesen, O. Uzel, S. Koca.
Toxic epidermal necrolysis after cranial radiotherapy and phenytoin treatment.
Onkologie, 27 (2004), pp. 389-392
[14.]
G.H. Cockey, S.T. Amann, S.B. Reents, J.W. Lynch Jr..
Stevens-Johnson syndrome resulting from whole-brain radiation and phenytoin.
Am J Clin Oncol, 19 (1996), pp. 32-34
[15.]
K.O. Duncan, R.E. Tigelaar, J.L. Bolognia.
Stevens-Johnson syndrome limited to multiple sites of radiation therapy in a patient receiving phenobarbital.
J Am Acad Dermatol, 40 (1999), pp. 493-496
[16.]
B. Vincenzi, D. Santini, C. Grilli, A. La Cesa, C. Dianzani, G. Tonini.
Complications of therapy in cancer patients: Case 3. Toxic epidermal necrolysis induced by oral phenobarbital and whole-brain radiotherapy in a breast cancer patient.
J Clin Oncol, 22 (2004), pp. 4649-4651
[17.]
K. Hoang-Xuan, J.Y. Delattre, M. Poisson.
Stevens-Johnson syndrome in a patient receiving cranial irradiation and carbamazepine.
Neurology, 40 (1990), pp. 1144-1145
[18.]
G. Micali, K. Linthicum, N. Han, D.P. West.
Increased risk of erythema multiforme major with combination anticonvulsant and radiation therapies.
Pharmacotherapy, 19 (1999), pp. 223-227
[19.]
D. Aguiar, R. Pazo, I. Durán, J. Terrasa, A. Arrivi, H. Manzano, et al.
Toxic epidermal necrolysis in patients receiving anticonvulsants and cranial irradiation: a risk to consider.
J Neurooncol, 66 (2004), pp. 345-350
[20.]
I. Ahmed, J. Reichenberg, A. Lucas, J.M. Shehan.
Erythema multiforme associated with phenytoin and cranial radiation therapy: a report of three patients and review of the literature.
Int J Dermatol, 43 (2004), pp. 67-73
[21.]
C.C. Vittorio, J.J. Muglia.
Anticonvulsant hypersensitivity syndrome.
Arch Intern Med, 155 (1995), pp. 2285-2290
[22.]
A.D. Cohen, E. Reichental, S. Halevy.
Phenytoin-induced severe cutaneous drug reactions: suspected interactions with corticosteroids and H2-blockers.
Isr Med Assoc J, 1 (1999), pp. 95-97
Copyright © 2007. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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