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Epilepsy Drug Dilantin can Lead to SJS, Life-Threatening Skin Reaction

Jul 19, 2016

Dilantin (phenytoin) is a drug approved to treat epilepsy. It is available in a chewable form, called Dilantin Infatabs, often given to young children. One rare, but possible side effect associated with Dilantin is Stevens-Johnson Syndrome (SJS), a life-threatening reaction that affects the skin and mucous membranes. If this condition affects more than 30 percent of the body, it is known as toxic epidermal necrolysis (TEN). The Epilepsy Foundation warns that SJS is a potential danger associated with Dilantin and Lamictal.

SJS and TEN frequently occurs as a reaction to a medication, but it can also be caused by cancers and infection. There is a risk of side effects with all drugs; some are more serious than others. Being aware of the potential side effects, symptoms, and risks versus benefits is useful for both patients and healthcare professionals.

SJS/TEN is a rare but serious side effect of Dilantin; it is considered a medical emergency requiring immediate hospitalization. Patients with SJS can be left with blindness or permanent skin damage. According to the Mayo Clinic, patients should seek emergency medical attention if they experience widespread skin pain, facial swelling, blisters on the skin and mucous membranes, hives, tongue swelling, a red or purplish skin rash that spreads, or shedding of the skin.

SJS is thought to be caused by an immune reaction that affects the skin and mucous membranes. In the early stages, patients often suffer from flu-like symptoms followed by a painful red or purplish rash. The rash spreads and blisters before the top layer of the skin dies and sheds. Depending on the severity of the reaction, recovery can take weeks to months, Mayo Clinic says.

SJS can also affect the eyes, and lead to conjunctivitis. In more serious cases, blindness can occur when scar tissue develops in the eyelids and scratches the cornea. Some reports link Dilantin to cases of blindness in children.

Some lawsuits have been filed over SJS/TEN and blindness allegedly caused by various drugs. One Massachusetts jury awarded $140 million to a young plaintiff who suffered from TEN. Reportedly, the condition destroyed 90 percent of her skin and left her blind. This verdict was particularly large, but other cases have also yielded substantial sums. In 2010, $10 million was awarded to the family of another young patient who suffered from SJS.

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