The Clinical Investigation of the Drug Eruption (Erythroderma type) Caused by Carbamazepine "Tegretol".

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  • Takino Chohei
    Department of Dermatology, Tokyo Medical and Dental University, School of Medicine
  • Miyazaki Kazuhiro
    Department of Dermatology, Tokyo Medical and Dental University, School of Medicine
  • Ohtaki Noriko
    Department of Dermatology, Tokyo Medical and Dental University, School of Medicine
  • Yamada Minoru
    Department of Dermatology, Mitsui Memorial Hospital

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Other Title
  • Carbamazepine "Tegretol" による薬疹(紅皮症型)の臨床的検討
  • Carbamazepine Tegretol ニ ヨル ヤクシン ベニ ヒショウガタ ノ リンショウテキ ケントウ

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Description

Three cases of the erythroderma caused by oral administration of carbamazepine were presented. From the clinical observation, the skin eruption was believed to be elicited by allergic mechanism of the drug. The allergenic site of carbamazepine was thought to be benzoazepine ring and carbon adjacent to nitrogen of the ring. There are, hitherto, a few reports on the eruption by this drug, but no test has been done to decide its criminality. All cases were males of older than 50 years. The important factors to elicite the skin eruption were the administration period (every day administration for more than 30 days) and the total amount of the drug (over 12g), but not the amount of the daily dose. Their rash had worsened to a generalized erythroderma within about 2 weeks with continuous administration of the drug. All cases had improved within 8 weeks at most by topical treatment. The eosinophilia was present in all cases. The eosinophilic leucocytes decreased in number with the improvement of the rash. Oral test, pach test and skin windown technique resulted positive reactions on all cases. In this paper, the importance of the detection of criminal drug was discussed, and the patch test and the skin window technique were recommended as detection methods, because these tests could be performed without any trouble and danger.

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