Abstract

Sarwamangala S. Nanjayyananamth, Nirupama Kulkarni, Sanatkumar B. Nyamagoud*, Usha D. S AHM Vishwanath Swamy and Varsha I. Dalal

ABSTRACT

Phenobarbitone is an anti-epileptic known to cause skin reactions in 1 to 3% of patients. Erythema multiforme is an acute, immune-mediated condition that is a type 4 hypersensitivity reaction that affects the skin and mucous membranes. Here we report a case of phenobarbitone-induced erythema multiforme of a 43-year-old female patient presenting to the hospital with complaints of loss of appetite for 15 days, and fever with chills for 3 days. She has had a medical history of seizures past 1 year and is on medications tablet phenytoin 100mg twice a day and tablet phenobarbitone 60 mg once a day at night. Symptoms intensified on continuing medication and subsided on withdrawal of medication. Hyperpigmentation lesions on the upper and lower limbs and abdomen were observed from 4 to 5 days. Phenobarbitone was discontinued from treatment on 28/4/2022. Since the patient was diagnosed with viral erythematous fever, the rechallenge was risky and life-threatening, dechallenge improved the patient’s condition hence based on the criteria of the WHO causality assessment scale, it was revealed as a probable/ likely adverse drug reaction.