DOI: 10.363247/sjmcr.2018.v06i10.014

Pages: 783-786

The antiseizure properties of the broad spectrum, non-aromatic sodium valproate are well known. It is being increasingly used in other conditions like bipolar disorders, acute mania, panic attacks and migraine. Non-aromatic antiepileptics are considered to be relatively safe and less likely to cause drug related cutaneous adverse reactions. Here, we report a case of a 20 year old female who was admitted to the dermatology ward with generalized erythema and exfoliation.. She had a history of focal seizures which first started in May, 2016. She was first treated with oxcarbazepine which was later changed to phenytoin due to recurrence after 18 months. Due to fever and itching after 2 months, she was switched over to sodium valproate along with the symptomatic treatment. Within 3-4 days, she developed erythema, first on the right upper limbs followed by left, then the lower limbs and gradually involved the whole body. She then came to the Dermatology OPD of RIMS where she was advised admission. On general examination, she had multiple hyperpigmented papules, some coalescing to form plaques, with edema of both hands. Generalised redness of the conjunctiva was seen along with oral candidiasis. Routine examinations of the blood and urine were done and were found to be normal. She was provisionally diagnosed with erythroderma due to valproate ingestion the drug was stopped. She was treated with iron, calcium, cetirizine and local application of vaseline. She recovered well and was discharged after seventeen days with healing of skin lesions with mild hyperpigmentation.