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Kazanci A, Tekkök İH. Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy. J Korean Neurosurg Soc. 2015;58(2):163-6doi: 10.3340/jkns.2015.58.2.163.
Kazanci, A., & Tekkök, �. �. H. (2015). Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy. Journal of Korean Neurosurgical Society, 58(2), 163-6. https://doi.org/10.3340/jkns.2015.58.2.163
Kazanci, Atilla, and Tekkök, İsmail Hakkı. "Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy." Journal of Korean Neurosurgical Society vol. 58,2 (2015): 163-6. doi: https://doi.org/10.3340/jkns.2015.58.2.163
Kazanci A, Tekkök İH. Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy. J Korean Neurosurg Soc. 2015 Aug;58(2):163-6. doi: 10.3340/jkns.2015.58.2.163. Epub 2015 Aug 28. PMID: 26361537; PMCID: PMC4564753.
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J Korean Neurosurg Soc. 2015 Aug;58(2):163-6. doi: 10.3340/jkns.2015.58.2.163. Epub 2015 Aug 28.

Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy.

Journal of Korean Neurosurgical Society

Atilla Kazanci, İsmail Hakkı Tekkök

Affiliations

  1. Department of Neurosurgery, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
  2. Department of Neurosurgery, Ankara Bay?nd?r Hospital, Ankara, Turkey.

PMID: 26361537 PMCID: PMC4564753 DOI: 10.3340/jkns.2015.58.2.163

Abstract

The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

Keywords: Cranial Radiotherapy; Erythema Multiforme; Phenytoin

References

  1. Neurology. 2007 May 15;68(20):1701-9 - PubMed
  2. Pharmacotherapy. 1999 Feb;19(2):223-7 - PubMed
  3. Am J Health Syst Pharm. 2008 Jun 1;65(11):1048-50 - PubMed
  4. Epilepsia. 1999 Mar;40(3):341-4 - PubMed
  5. Lancet. 1999 Jun 26;353(9171):2190-4 - PubMed
  6. Intern Med J. 2005 Mar;35(3):188-90 - PubMed
  7. Onkologie. 2004 Aug;27(4):389-92 - PubMed
  8. J Cutan Pathol. 1990 Apr;17(2):111-6 - PubMed
  9. J Dtsch Dermatol Ges. 2005 Jan;3(1):39-43 - PubMed
  10. N Engl J Med. 1995 Dec 14;333(24):1600-7 - PubMed
  11. Epilepsia. 2007 May;48(5):1015-8 - PubMed
  12. J Eur Acad Dermatol Venereol. 2003 Jul;17(4):399-401 - PubMed
  13. Int J Dermatol. 2004 Jan;43(1):67-73 - PubMed
  14. Neurology. 2005 Apr 12;64(7):1134-8 - PubMed
  15. Epilepsia. 1991 Jul-Aug;32(4):554-9 - PubMed

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