RT Journal Article
SR Electronic
T1 Toxic epidermal necrolysis in a patient receiving concurrent phenytoin and whole brain and thoracic radiotherapy
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1393
OP 1395
VO 35
IS 11
A1 Ahmed, Imtiaz
A1 Biswas, Ahitagni
A1 Krishnamurthy, Sapna
A1 Julka, Pramod K.
YR 2014
UL http://smj.org.sa/content/35/11/1393.abstract
AB Toxic epidermal necrolysis (TEN) is a severe drug induced type IV hypersensitivity syndrome that can be caused by anticonvulsant drugs, especially the aromatic anticonvulsants such as phenytoin. Most patients with brain metastasis receive whole brain radiotherapy along with anti-edema measures and anticonvulsants either as prophylactic or for symptom control; phenytoin being the most commonly used drug. In a subset of patients, cranial irradiation may act as a precipitating factor along with anticonvulsants for the development of TEN. We report a 54-year-old patient with metastatic non-small cell lung cancer treated with palliative whole brain and mediastinal radiotherapy with concurrent phenytoin-developing TEN, which started within the radiation portals with subsequent generalization. Though a rare, but serious complication, avoidance of the use of phenytoin concurrent with radiotherapy, replacing phenytoin with newer anticonvulsants, early recognition, aggressive management and awareness of this possible complication has been implied upon in this report.