Cutaneous reactions management

Ruble J, Matsuo H. Anticonvulsant-induced cutaneous reactions. Incidence, mechanisms and management. CNS Drugs 1999 12 215-36. 

Topical formulations of nystatin and of amphotericin B are useful in the management of Candida albicans infections of the skin. Both antibiotics are ineffective against dermatophytes. The use of nystatin is limited to topical treatment of cutaneous and mucosal Candida infections because of its narrow spectrum and its negligible absorption from the gastrointestinal tract. Hypersensitivity reactions are rare. It is not known whether topical nystatin can cause fetal harm when used by a pregnant woman. Amphotericin B has broader antifungal activity but its topical use is restricted to Candida. Topical use of amphotericin B has shown minimal absorption through the skin and is well tolerated. Limited human surveillance data do not indicate any harm to mother or fetus, but relative safety is still unknown. 

Skin Allopurinol has commonly been implicated in Stevens—Johnson syndrome and toxic epidermal necrolysis [85 ]. This association has been confirmed by an analysis from Singapore. Of 85 cases of Stevens-Johnson syndrome and toxic epidermal necrolysis managed in Singapore from 2003 to 2007, allopurinol was implicated in 13 cases [86 ]. The HLA-B 5801 allele is associated with severe cutaneous adverse reactions caused by allopurinol in the Han Chinese population [87 ]. The association between allopurinol-related Stevens-Johnson syndrome and toxic epidermal necrolysis and HLA-B 5801 has also been confirmed in Thai and Japanese patients [88 89. ... 

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