Carbamazepine-induced erythema multiforme major in an epileptic patient with bipolar affective disorder.

Carbamazepine (CBZ) is frequently used for epilepsy and various psychiatric illnesses. It is known for its dermatological side effects which may range from mild rash to life-threatening reactions as Stevens Johnson syndrome or toxic epidermal necrolysis. We hereby report a rare case of 17-year-old woman suffering from generalized tonic clonic epilepsy with comorbid bipolar affective disorder, who was initially treated with sodium valproate with partial improvement. After 19 days of addition of CBZ to the therapy, the patient developed erythema multiforme major with >60% skin involvement and oral, conjunctival, intestinal, and vaginal mucosal involvement.