Lichenoid Drug Eruption in the Setting of Lamotrigine and Amoxicillin: A Case Report: Lichenoid Drug Eruption in the Setting of Lamotrigine and Amoxicillin

Authors

Nina Cheng, Drexel University College of Medicine
Shaymaa Ashi, Department of Dermatology, St. Luke’s University Health Network, Bethlehem, PA
Giuseppe Militello, Dermatology Private Practice, Greenvale, NY
Douglas Degler, Department of Medicine, St. Luke’s University Health Network, Monroe, PA

Document Type

Article

Abstract

A 43-year-old female with a 5-week history of lamotrigine use presented with a rash over the neck and torso following 2 days of amoxicillin for acute pharyngitis. Despite antibiotic discontinuation, the rash progressed to confluent erythematous papules across the face, trunk, extremities, palms, and soles. Persistent fever, severe lymphadenopathy, and angioedema ensued, with leukocytosis, thrombocytosis, neutrophilia, elevated ESR and CRP. Punch biopsy revealed lichenoid drug eruption with prominent histiocytic components and rare eosinophils. Patient improved after lamotrigine discontinuation with prednisone 80 mg to 20 mg tapered over 8 days. This is the first report of a lichenoid drug eruption in the setting of lamotrigine. Lamotrigine is associated with many cutaneous reactions; this risk may be potentiated in the setting of antibiotic therapy.

Publication Date

1-16-2024

Recommended Citation

Cheng N, Ashi S, Militello G, Degler D. Lichenoid Drug Eruption in the Setting of Lamotrigine and Amoxicillin: A Case Report: Lichenoid drug eruption in the setting of lamotrigine and amoxicillin. SKIN The Journal of Cutaneous Medicine. 2024 Jan 16;8(1):1306-10.