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Hi guys, I'm new to the forum and newly diagnosed bipolar 2 after being misdiagnosed for ten years with anxiety, then major depressive disorder and finally in November, bp2. I'm on Lamictal, which so far I like. This week we increased to 150mg. I'm always itchy after an increase but usually no rash. I do also have eczema on occasion especially when I'm getting sweaty. On these meds I'm still having night sweats and in the creases of my armpits I'm getting what I think is eczema... And I scratched. I know, never scratch so now I have a little patch that's not bumpy but a little purple. Anyone know how to tell the difference between eczema and early signs of Steven's Johnson's Syndrome?

Edited by JazB2
Typo

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I'm no expert or anything, but eczema is something that is more chronic and long-standing, whereas Stevens-Johnson Syndrome (SJS) is something that develops over the period of a short time with more symptoms than just topical skin symptoms. SJS includes symptoms like fever, flu-like symptoms, and painful lesions that form over the rashes. These lesions usually form around the mouth and can make it very painful and difficult to eat or drink. Conjunctivitis is also common with SJS and if not caught early enough can cause the eyes to swell shut. The rash can be purple in color though, so that alone concerns me (even though the same thing happened to me, and when I went to the doctor about it he said I didn't have SJS). Basically, from what I gathered, SJS is something you KNOW you have when you have it, but still, if you have any doubts in your mind as to whether you think you may have SJS, you really need to go to the ER immediately, as SJS is a medical emergency that requires immediate medical attention, even if it's not really SJS, because it's nothing to play around with.

The problem with Lamictal is that it can cause a whole bunch of skin issues, rashes, itchiness, and with me, acne (horrible!), and it can cause pdocs and gdocs alike to freak out and take people off the medicine thinking their patient is developing SJS when they might just be developing a benign rash. My keratosis pilaris flared up something awful too when I was on it. It's just a bad medicine for skin conditions... 

But really, if you think you have some of the symptoms of SJS in its beginnings, seek immediate medical attention.

Best of luck to you! I hope you don't have SJS, because if Lamictal is helping you, it's a good medicine despite its troublesome dermatological side effects.

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Have a look at this:

https://www.dermnetnz.org/topics/anticonvulsant-drugs-and-the-skin/

And if all else fail, see your dermatologist. I’ve been taking LTG for years, and it’s done all kinds of crazy shit to my already sensitive skin. You would not believe how dry my skin is now. Bug bites can take weeks to heal, as can any minor cut or scrape. I scar more easily. Don’t even get me started on the sunburns.

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When I went on Lamictal my psychiatrist told me that if I got a rash I should just call his office and he would fit me in any time and exclude SJS so that I could keep taking the medication. He said about half his patients end up getting some kind of rash at some time during the titration period because the titration period is so long, and rashes can appear for any reason or sometimes no known reason at all. Especially in someone who has eczema, or had it as a child like I did. He was annoyed with people in the ER who would take anyone with a rash off Lamictal while barely looking at it, because while SJS can be really bad, so can untreated bipolar disorder. With the difference being that people who are taking Lamictal often do have untreated bipolar disorder and despite the rash are unlikely to have SJS.

If you didn't go to the ER durinng the weekend, I suggest you treat it like eczema for the time being and call your doctor Monday morning. If you freak out and stop you might have to start the titration schedule all over again, so if it was me I would just keep taking it unless the rash was crearly spreading. Not everyone would though. My thinking is Monday is just hours from now, and your psychiatrist is more likely to see the whole picture instead of simply freaking out and completely eliminating all risk of being sued at the expense of what might be your best treatment option. Maybe that's just me being cynical. Good luck with Lamictal :)

 

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On 1/27/2018 at 10:27 PM, Gearhead said:

Have a look at this:  https://www.dermnetnz.org/topics/anticonvulsant-drugs-and-the-skin/

And if all else fail, see your dermatologist. I’ve been taking LTG for years, and it’s done all kinds of crazy shit to my already sensitive skin. You would not believe how dry my skin is now. Bug bites can take weeks to heal, as can any minor cut or scrape. I scar more easily. Don’t even get me started on the sunburns.

Thanks for posting Gearhead! I've been on Lamictal for over a year. It's been good, minimal side effects, luckily no acne issues at all. But I have noticed my skin is itchy & insanely dry (I thought it was just the winter) and mosquito bites?!! OMG, I made the mistake of scratching and I have big round scars now over a month later! Weird!

Is there a good moisturizing body lotion (without alot of chemicals/parabens) that you recommend? I have used all kinds (from Nivea, vaseline intensive, Neutrogena, among many) and they really don't work well. They don't absorb and leave this thick waxy-like coating on your skin that is gross, you can literally scrape it off.

Edited by Blahblah

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53 minutes ago, Blahblah said:

Is there a good moisturizing body lotion (without alot of chemicals/parabens) that you recommend? I have used all kinds (from Nivea, vaseline intensive, Neutrogena, among many) and they really don't work well. They don't absorb and leave this thick waxy-like coating on your skin that is gross, you can literally scrape it off.

Baby oil. Trust me.

Also, it'll feel disgusting when you put it on (at least it does for me). The gel is a little bit easier to manage, if you can find it. Ime it's pretty much the only thing that skin that won't absorb cream can handle.

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I see a dermatologist regularly, luckily, so if I have any concerns about any rashes or strange spots that pop up or something, I can address it with her. She always seems to know what to do and has good advice about what to do, whether I need to just use an OTC lotion/cream/gel/oil/etc. or whether she needs to prescribe a prescription steroid/antifungal ointment/lotion/cream/etc. She's really good about getting work-ins also if there's any concerning rash that flares up. She knows that I have bipolar plus a bunch of other health issues for which I have to take a myriad of medicines, and seems to understand how each of them might interact with my skin.

Finding a good dermatologist might be a good idea especially if you're on an anticonvulsant, especially one like Lamictal. The wait time to be seen might be a while but once you are seen it's worth it.

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Whenever I titrate an AED, I feel itchy all over, but it passes. I've been on lamotrogine for roughly 10 years. I do get minor rashes on my forearms and very rarely on my shins.  My husband takes it, and has a pretty bad rash on his shins, but it's definitely not SJS. And if he stopped scratching it, and making it bleed, it might not look so bad.

I am going to suggest the baby oil idea to DH, but we currently use Lubriderm® Advanced Therapy Lotion For Extra Dry Skin

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I have eczema and also got the rash on lamicatal. You sill know the difference, or atleast I did. Something was not right. I’ll post a pic of it but warning it’s gross af. I got it all around my lips and chin. Itchy, swollen, couldn’t open my mouth. Went to Er and was confirmed it was the rash. Two days after stopping lamictal it was completely gone. I just have the worst luck with medications lol 

B632AA3D-2B47-4F6D-8CCB-B196E3D777E9.jpeg

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On 2/3/2018 at 10:38 AM, crtclms said:

Whenever I titrate an AED, I feel itchy all over, but it passes. I've been on lamotrogine for roughly 10 years. I do get minor rashes on my forearms and very rarely on my shins.  My husband takes it, and has a pretty bad rash on his shins, but it's definitely not SJS. And if he stopped scratching it, and making it bleed, it might not look so bad.

I am going to suggest the baby oil idea to DH, but we currently use Lubriderm® Advanced Therapy Lotion For Extra Dry Skin

Apologies for the hijack, but I see you have gabapentin as one of your former RX. Did you also get itchy all over when you were titrating gabapentin?

I seem to be having an issue with itchiness (but no rash).

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On 1/31/2018 at 4:31 AM, Blahblah said:

 Is there a good moisturizing body lotion (without alot of chemicals/parabens) that you recommend? I have used all kinds (from Nivea, vaseline intensive, Neutrogena, among many) and they really don't work well. They don't absorb and leave this thick waxy-like coating on your skin that is gross, you can literally scrape it off.

My daughter (she's not on any meds), has occasional eczema flare-ups, and uses organic, cold-pressed, virgin coconut oil for the eczema......Works well for her every time, and it's chemical free.

You can usually find this type of coconut oil in the grocery store, or a health food store like Vitamin Shoppe....Be sure you get the organic, cold-pressed kind if you ever want to try it.

Just my 2 cents.

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