Lichenoid Drug Eruption in the Setting of Lamotrigine and Amoxicillin: A Case Report Lichenoid drug eruption in the setting of lamotrigine and amoxicillin

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Nina Cheng
Shaymaa Ashi
Giuseppe Militello
Douglas Degler


lichenoid drug eruption, lamotrigine, amoxicillin, antiepileptic, antibiotic, case report


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.


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