TY  - JOUR
T1  - A Rare Case Of Severe Cutaneous Reactıon Assocıated Wıth Hıgh-Dose Quetıapıne In The Emergency Department
AU  - Akben, Seval
AU  - Gedik, Muhammed Semih
AU  - Mangir, Lütfiye
PY  - 2025
DA  - August
Y2  - 2025
DO  - 10.51262/ejtox.1713667
JF  - Eurasian Journal of Toxicology
JO  - Eurasian J Tox
PB  - Acil Tıp Uzmanları Derneği
WT  - DergiPark
SN  - 2667-8675
SP  - 37
EP  - 39
VL  - 7
IS  - 2
LA  - en
AB  - AbstractAntipsychotic drugs are widely used to treat psychiatric disorders such as schizophrenia and bipolar disorder. They rarely cause serious adverse reactions affecting the skin. This case report describes a rare dermatological adverse reaction characterised by widespread skin lesions, blister formation and epidermal peeling in a 40-year-old male patient taking ketiapine in excess of the recommended dosage. Following clinical evaluation, the possibility of a drug reaction preceding Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) was considered. Discontinuing the medication and providing appropriate symptomatic treatment resulted in the patient experiencing rapid clinical improvement. This case highlights the importance of the emergency department recognising rare but potentially serious skin reactions associated with atypical antipsychotics early on.
KW  - Quetiapine
KW  - Cutaneous adverse reactions
KW  - Stevens–Johnson syndrome
KW  - High-dose drug use
KW  - Emergency department
CR  - Ceraso A, Lin J, Schneider-Thoma J, Siafis S, Heres S, Kissling W, et al. Maintenance treatment with antipsychotic drugs in schizophrenia: A Cochrane systematic review and meta-analysis. Schizophr Bull. 2022. doi:10.1093/schbul/sbac041
CR  - Rybakowski J. Application of antipsychotic drugs in mood disorders. Brain Sci. 2023;13(3):414. doi:10.3390/brainsci13030414
CR  - Feng X, Li Z, Li Z, Tan X, Zhao Y, Zhu W, et al. Effectiveness and safety of second-generation antipsychotics for psychiatric disorders apart from schizophrenia: A systematic review and meta-analysis. Psychiatry Res. 2023;332:115637. doi:10.1016/j.psychres.2023.115637
CR  - Owen C, Jones J. Recognition and management of severe cutaneous adverse drug reactions (including drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis). Med Clin North Am. 2021;105(4):577–97. doi:10.1016/j.mcna.2021.04.001
CR  - Wang L, Varghese S, Bassir F, Lo Y, Ortega C, Shah S, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review of PubMed/MEDLINE case reports from 1980 to 2020. Front Med. 2022;9:949520. doi:10.3389/fmed.2022.949520
CR  - Shah H, Parisi R, Mukherjee E, Phillips E, Dodiuk-Gad R. Update on Stevens–Johnson syndrome and toxic epidermal necrolysis: Diagnosis and management. Am J Clin Dermatol. 2024;25(4):891–908. doi:10.1007/s40257-024-00889-6
CR  - Stewart T, Chan C, Shah H, Frew J. Infectious complications of Stevens-Johnson syndrome and toxic epidermal necrolysis: A systematic review and meta-analysis. Int J Dermatol. 2024. doi:10.1111/ijd.17527
CR  - Biju R, Davis S, Sanal G. Quetiapine-induced drug rash with eosinophilia and systemic symptom syndrome. J Med Sci. 2022;42(3):242–4.doi:10.4103/jmedsci.jmedsci_82_21
CR  - Del Pozzo-Magaña BR, Liy-Wong C. Drugs and the skin: A concise review of cutaneous adverse drug reactions. Br J Clin Pharmacol. 2024;90(8):1838–55. doi:10.1111/bcp.15490
CR  - Frantz R, Huang S, Are A, Motaparthi K. Stevens–Johnson syndrome and toxic epidermal necrolysis: A review of diagnosis and management. Medicina (Kaunas). 2021;57(9):895. doi:10.3390/medicina57090895
CR  - Tan E, Robson A, Lai-Cheong J, Wain E. Interstitial granulomatous drug reaction induced by quetiapine. Clin Exp Dermatol. 2016;41. doi:10.1111/ced.12662
CR  - Cadot R, Gery P, Lenief V, Nicolas JF, Vocanson M, Tauber M. Exploring recent advances in drugs severe cutaneous adverse reactions immunopathology. Allergy. 2025;80(1):47–62. doi:10.1111/all.16316
CR  - Kjaer HF, Mortz CG, Bindslev-Jensen C. Does treatment with antidepressants, antipsychotics, or benzodiazepines hamper allergy skin testing? Clin Transl Allergy. 2021;11(7):e12060. doi:10.1002/clt2.12060
CR  - Gedik MS, Hakkoymaz H, Kilci Aİ, Küçük ÖF. General approach to cases of drug intoxication. Eurasian J Crit Care. 2023;5(1):17–21. doi:10.55994/ejcc.1237689
CR  - Bliss S, Warnock J. Psychiatric medications: Adverse cutaneous drug reactions. Clin Dermatol. 2013;31(1):101–9. doi:10.1016/j.clindermatol.2011.11.014
UR  - https://doi.org/10.51262/ejtox.1713667
L1  - https://dergipark.org.tr/en/download/article-file/4933802
ER  -