Phenytoin-Induced Hypersensitivity Syndrome Presenting on the Palms and Soles of an 18-Year-Old Woman

Anticonvulsant drug-induced hypersensitivity syndrome (DIHS) is a disorder that occurs in some patients taking anticonvulsant medications. Fever is the most common feature, seen in 90-100% of cases. It is also characterized by rash, hepatitis, and other multiorgan involvement. The mechanism is unknown. Implicated anticonvulsants include those in the phenytoin category, carbamazepine,and lamotrigine [1]. This syndrome is now most commonly known as Drug Reaction (or Rash) with Eosinophilia and Systemic Symptoms (DRESS), a term more descriptive of its presentation. It is also known as Drug-Induced Delayed Multiorgan Hypersensitivity Syndrome (DIDMOHS) and Drug-Induced Pseudolymphoma. Anticonvulant hypersensitivity syndrome is an older term that has lost favor due to the fact that, aside from antiepileptics, other medications such as sulfonamides and allopurinol have been implicated. We report an 18-year-old woman who presented with drug-induced hypersensitivity syndrome secondary to phenytoin.