Sodium valproate-induced cutaneous pseudolymphoma followed by recurrence with carbamazepine

Br J Dermatol. 2001 Jun;144(6):1235-8. doi: 10.1046/j.1365-2133.2001.04240.x.

Abstract

We report a patient with a sodium valproate-induced cutaneous pseudolymphoma, presenting with an erythematous papule, histologically mimicking a non-epidermotropic T-cell lymphoma. Polymerase chain reaction study of the skin biopsy revealed monoclonal rearrangement of the T-cell receptor gamma gene. Withdrawal of sodium valproate was followed by regression of the lesion, but 5 months after substitution by carbamazepine, two further papules appeared, with similar histological features and a T-cell clone identical to the initial one. Carbamazepine was stopped and the lesions disappeared without relapse over a 4-year follow-up. Sodium valproate is very rarely responsible for a hypersensitivity syndrome, and our case is the first report of sodium valproate-induced cutaneous pseudolymphoma. The recurrence with carbamazepine may be due to a common effect on T-cell lymphocyte function. The return of the same monoclonal population shows that the recurrence of monoclonal T cells may be observed in benign conditions and is not an exclusive hallmark of cutaneous lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects*
  • Carbamazepine / adverse effects*
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Humans
  • Male
  • Pseudolymphoma / chemically induced*
  • Pseudolymphoma / pathology
  • Recurrence
  • Valproic Acid / adverse effects*

Substances

  • Anticonvulsants
  • Carbamazepine
  • Valproic Acid