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Dermatology (Expert Forum)
Sunburn-like rash from Lamictal
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
Sunburn-like rash from Lamictal
by nacho1, Aug 16, 2005 12:00AM
My question is: how long can sunburn-like rash symptoms last after discontinuing Lamictal and what treatment methods are best? Here's what happened:
6/6/05: started Lamictal 12.5mg/day
6/13/05: dose increase to 25mg/day
6/23/05: dose increase to 50mg/day
6/25/05: visible rash (red blotches) on chest after playing golf in blazing sun for 5 hours
6/26/05: discontinued all Lamictal
6/27/05: visible rash went away
However, since 6/27/05, I developed progressive skin redness, like a sunburn, on my chest. This sunburn-like redness has slowly spread to my whole body, but is mostly concentrated on my chest, neck, and arms. It's now 8/16/05 and my sunburn-like symptoms persist. I have been taking Zyrtec and applying Sarna per my PCP's orders for about 4 weeks now. I was also given some Dermatop samples to apply to localized areas when the redness gets worse (this helps, but causes acne). It should be noted that at least over the past 3 weeks I've stayed out of the sun (except for brief periods).
Between 7/1/05 and 7/27/05, I had 3 blister-like sores appear (one on my wrist, leg and knee--all about 1 week apart). These sores went away after about 24 hours but they're still somewhat visible, like a scar.
My mouth and hands are particularly sensitive. I have no sores in my mouth, but even the friction of my teeth seem to make my mouth sensitive. Mildly hot (temp.) foods also cause my mouth to become tender.
I've seen my PCP, and a dermatologist. I even went to the ER when a blister-like sore broke out. All docs have told me that I had an allergic reaction to the Lamictal, that my condition--although uncomfortable--is not life threatening. Most recently my dermatologist's PA told me that she's seen people take up to 6 months before the sunburn-like effect and skin sensitivity become dramatically reduced.
I've never had a fever during this time, nor any mucus membranes adversely affected. My skin prior to the Lamictal had been perfectly fine for my 32 years of age.
I go for days feeling OK, and managing the symptoms as prescribed. However, I'm writing because I sometimes become fearful that this could evolve into TEN or SJS--even at this late stage. I also become anxious that this sunburn-like effect will never go away. I know that you can't be 100% certain, but is there cause for any rational worry that things could get life threatening, or seriously debilitating?
As per my original question, can it take 6+ months before my symptoms may go away? In addition, should I petition my dermatologist to prescribe me prednisone, or another course of treatment besides Zyrtec, Sarna lotion, and occasional Dermatop?
Thank you.
6/6/05: started Lamictal 12.5mg/day
6/13/05: dose increase to 25mg/day
6/23/05: dose increase to 50mg/day
6/25/05: visible rash (red blotches) on chest after playing golf in blazing sun for 5 hours
6/26/05: discontinued all Lamictal
6/27/05: visible rash went away
However, since 6/27/05, I developed progressive skin redness, like a sunburn, on my chest. This sunburn-like redness has slowly spread to my whole body, but is mostly concentrated on my chest, neck, and arms. It's now 8/16/05 and my sunburn-like symptoms persist. I have been taking Zyrtec and applying Sarna per my PCP's orders for about 4 weeks now. I was also given some Dermatop samples to apply to localized areas when the redness gets worse (this helps, but causes acne). It should be noted that at least over the past 3 weeks I've stayed out of the sun (except for brief periods).
Between 7/1/05 and 7/27/05, I had 3 blister-like sores appear (one on my wrist, leg and knee--all about 1 week apart). These sores went away after about 24 hours but they're still somewhat visible, like a scar.
My mouth and hands are particularly sensitive. I have no sores in my mouth, but even the friction of my teeth seem to make my mouth sensitive. Mildly hot (temp.) foods also cause my mouth to become tender.
I've seen my PCP, and a dermatologist. I even went to the ER when a blister-like sore broke out. All docs have told me that I had an allergic reaction to the Lamictal, that my condition--although uncomfortable--is not life threatening. Most recently my dermatologist's PA told me that she's seen people take up to 6 months before the sunburn-like effect and skin sensitivity become dramatically reduced.
I've never had a fever during this time, nor any mucus membranes adversely affected. My skin prior to the Lamictal had been perfectly fine for my 32 years of age.
I go for days feeling OK, and managing the symptoms as prescribed. However, I'm writing because I sometimes become fearful that this could evolve into TEN or SJS--even at this late stage. I also become anxious that this sunburn-like effect will never go away. I know that you can't be 100% certain, but is there cause for any rational worry that things could get life threatening, or seriously debilitating?
As per my original question, can it take 6+ months before my symptoms may go away? In addition, should I petition my dermatologist to prescribe me prednisone, or another course of treatment besides Zyrtec, Sarna lotion, and occasional Dermatop?
Thank you.
Doctor's Answer
by Alan Rockoff, MD, Aug 18, 2005 12:00AM
, Aug 18, 2005 12:00AM
I have no personal experience with Lamictal rashes, and my literature search has not yielded anything helpful. Stevens-Johnson syndrome is a dramatic and acute situation, so you certainly don't have that and don't need to worry it will develop into that. I suggest you check with your dermatologist about ways to make your skin more comfortable as well as any other diagnostic tests (such as skin biopsy) which might clarify the situation. You certainly should make your dermatologist aware of your discomfort and the range of your concerns.
Best.
Dr. Rockoff
Best.
Dr. Rockoff
To clarify, TEN is also an unlikely evolution in your opinion?
Dr. Rockoff