Dermatology Letter

Created by

Fiona Campbell

Specialty

Dermatologist

Last edited

10/20/2026

Uses

0 times

Reason for Visit

You attended the clinic today for evaluation of a new, itchy rash on your trunk and limbs that started three weeks ago after your neurologist increased the dose of your seizure medication.

Medical History

You have a history of focal epilepsy, which was diagnosed two years ago, as well as mild childhood eczema.

Medications

You are currently taking lamotrigine (Lamictal®) 100 mg PO BID for your seizures.

Allergies

You have a known allergy to penicillin, which causes hives.

Social History

You work as an office manager, do not smoke, and drink alcohol occasionally on weekends.

Examination Findings

On examination of your skin today, you had a widespread, symmetrical red rash consisting of flat and slightly raised spots across your chest, back, and upper arms. Your temperature was normal at 36.8 °C, and there was no blistering of the skin or involvement of the lining of your mouth or eyes.

Investigations

We performed baseline blood tests today, including a full blood count, liver function tests, and kidney function tests, to ensure there is no internal inflammation.

Diagnosis

You have a benign drug-induced skin eruption likely triggered by the recent increase in your lamotrigine dose.

Management Plan

I have prescribed betamethasone valerate (Betnovate®) 0.1 % ointment to be applied topically BID to the affected areas for 14 days, alongside an emollient cream to use as a soap substitute. I have spoken with your neurology team, and we agreed that you should reduce your lamotrigine dose back to 50 mg PO BID while they arrange an alternative medication for you. You must seek urgent medical attention if you develop a high fever, skin blistering, or soreness in your mouth or eyes, and we will review your progress in the clinic in four weeks.

Please contact me if you have questions or need any additional information.

Yours sincerely,

Dr Sarah Jenkins

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