Reversible bilateral postauricular adult seborrheic dermatitis due to sodium valproate-valproic acid combination

Yıl 2024, Cilt: 5 Sayı: 2, 82 - 86, 31.05.2024

Mehmet Hamdi Örüm , Dilek Örüm , Osman Çevik

https://doi.org/10.55665/troiamedj.1426438

Öz

The combination of sodium valproate-valproic acid, commonly used to treat epilepsy and bipolar disor-der, may result in cutaneous reactions. In this case report, we presented a bilateral postauricular sebor-rheic dermatitis associated with sodium valproate-valproic acid use. A sodium valproate-valproic acid combination was introduced to the therapy of a 68-year-old male patient who had been diagnosed with schizophrenia and was on clozapine in order to potentially avoid seizures associated to the medication. On the fifteenth day of drug addition, crusting appeared on the back skin of both ears of the patient. While the patient had a history of clozapine use, there was no history of sodium valproate use or similar cutaneous symptoms. The current condition was associated with the sodium valproate-valproic acid combination and the drug was discontinued. Following discontinuation of the medication, the crusting decreased and disappeared completely after two weeks. The patient's schizophrenia-related treatment was completed and he was discharged. No cutaneous reaction was observed again during follow-up. It should be noted that cutaneous reactions may be associated with the use of sodium valproate-valproic acid combination.

Anahtar Kelimeler

Sodium valproate, valproic acid, side effects, seborrheic dermatitis

Sodyum valproat-valproik asit kombinasyonuna bağlı iki taraflı postauriküler erişkin seboreik dermatiti

Öz

Bipolar bozukluk ve epilepsi tedavisinde sıklıkla kullanılan sodyum valproat-valproik asit kombinasyonu kutanöz reaksiyonlara neden olabilir. Bu olgu sunumunda sodyum valproat-valproik asit kullanımına bağlı gelişen iki taraflı postau-riküler seboreik dermatiti sunduk. Şizofreni tanısıyla klozapin kullanmaya başlayan 68 yaşındaki erkek hastada, klozapine bağlı olası nöbetlerin önlenmesi amacıyla tedaviye sodyum valproat-valproik asit kombinasyonu eklendi. İlaç ilavesinin onbeşinci gününde hastanın her iki kulağının arka derisinde kabuklanma oluştu. Hastanın özgeçmişinde klozapin kullanım öyküsü mevcutken, sodyum valproat kullanımı ya da benzeri kutanöz semptomu öyküsü yoktu. Mevcut durum sodyum valproat-valproik asit kombinasyonuna bağlandı ve ilaç kesildi. İlacın kesilmesini takiben kabuklanmalar azaldı ve iki hafta sonra tamamen ortadan kalktı. Hastanın şizofreni tedavisi tamamlanarak taburcu edildi. Takip sırasında yeniden herhangi bir kutanöz reaksiyon gözlenmedi. Sodyum valproat-valproik asit kombinasyonunun kullanımıyla kutanöz reaksiyonların ortaya çıkabileceği unutulmamalıdır.

Anahtar Kelimeler

Sodium valproat, valproik asit, yan etkiler, seboreik dermatit

Kaynakça

• 1. Williams AM, Park SH. Seizure associated with clozapine: incidence, etiology, and management. CNS Drugs 2015;29(2):101–11.
• 2. Zhu MM, Li HL, Shi LH, Chen XP, Luo J, Zhang ZL. The pharmacogenomics of valproic acid. J Hum Genet 2017;62(12):1009–14.
• 3. Swaiman KF, Ashwal S. Pediatric Neurolo-gy Principles and Practice. St. Louis, Mis-souri: Mosby, 3th Edition, 1999; 629–718.
• 4. https://titck.gov.tr/storage/Archive/2020/kubKtAttachments/UYGUNKT_a3ee1b7b-cfc3-41af-b96c-4494a0928734.pdf. Date of Access: 14/10/2023.
• 5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA.
• 6. Devinsky O, Honigfeld G, Patin J. Clozap-ine-related seizures. Neurology 1991;41(3):369–71.
• 7. Kose S, Akin E, Cetin M. Adverse drug re-actions and causality: The Turkish version of naranjo adverse drug reactions probabil-ity scale. Psychiatry Clin Psychopharmacol 2017;27(2):205–6.
• 8. Biondo-Simões R, Biondo-Simões MLP, Ioshii SO, Robes RR, Dall'Antonia MO. The effects of valproic acid on skin heal-ing: experimental study in rats. Acta Cir Bras 2022;37(4):e370403.
• 9. Giménez-García R, Carrasco-Molina S, Zambrano-Centeno B. Valproic acid-induced hyperpigmentation. ARC Journal of Dermatology 2017;2(1):16–8.
• 10. Rashid M, Kashyap A, Undela K. Valproic acid and Stevens-Johnson syndrome: a systematic review of descriptive studies. Int J Dermatol 2019;58(9):1014–22.
• 11. Ferzli GT, El-Tal Ael-K, Kibbi AG, Mikati MA. Localized morphea: a rare adverse ef-fect of valproic acid. Pediatr Neurol 2003;29(3):253–5.
• 12. Kacalak-Rzepka A, Kiedrowicz M, Bielec-ka-Grzela S, Ratajczak-Stefanska V, Maleszka R, Mikulska D. Rowell's syn-drome in the course of treatment with so-dium valproate: a case report and review of the literature data. Clin Exp Dermatol 2009;34(6):702–4.
• 13. Sahu P, Sahoo SK, Dayal S, Khanna J. Acute generalized exanthematous pustulo-sis secondary to Valproate: An uncommon cutaneous reaction of a common drug. J Young Pharm 2016;8(1):56–8.
• 14. Cogrel O, Beylot-Barry M, Vergier B, et al. Sodium valproate-induced cutaneous pseudolymphoma followed by recurrence with carbamazepine. Br J Dermatol 2001;144(6):1235–8.
• 15. Koumaki D, Papadavid E, Panayiotides I, Shtukkert E, Dinopoulos A, Rigopoulos D. Henoch-Schönlein purpura in a child in-duced by valproic acid. Clin Transl Allergy 2015;5(1):15.
• 16. Gul Mert G, Incecik F, Gunasti S, Herguner O, Altunbasak S. Psoriasiform drug erup-tion associated with sodium valproate. Case Rep Pediatr 2013;2013:823469.
• 17. Bliss SA, Warnock JK. Psychiatric medica-tions: adverse cutaneous drug reactions. Clin Dermatol 2013;31(1):101–9.
• 18. Brenner S, Wolf R, Landau M, Politi Y. Psoriasiform eruption induced by anticon-vulsants. Isr J Med Sci 1994;30(4):283¬–6.
• 19. Diaz-Perez JA, Joyce JC, Cibull TL, Victor TA. Development of Pityriasis Amiantacea after Valproic Acid Therapy. Int J Trichol-ogy 2018;10(5):237¬–9.
• 20. Gupta LK, Khare AK, Masatkar V, Mittal A. Pityriasis amiantacea. Indian Dermatol Online J 2014;5(1):63–4.
• 21. Clark GW, Pope SM, Jaboori KA. Diagno-sis and treatment of seborrheic dermatitis. Am Fam Physician 2015;91(3):185–90.
• 22. Tucker D, Masood S. Seborrheic Dermati-tis. [Updated 2023 Feb 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551707/.
• 23. Tsankov N, Angelova I, Kazandjieva J. Drug-induced psoriasis: recognition and management. Am J Clin Derma-tol 2000;1(3):159–65.
• 24. Misery L, Touboul S, Vinçot C, Dutray S, Rolland-Jacob G, Consoli SG, Farcet Y, Fe-ton-Danou N, Cardinaud F, Callot V, De La Chapelle C, Pomey-Rey D, Consoli SM; Pour le Groupe Psychodermatologie. Stress and seborrheic dermatitis. Ann Dermatol Venereol 2007;134(11):833–7