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Missed Diagnosis of Epilepsy-Associated Scald Burns: Two Cases Initially Diagnosed as Bullous Dermatosis.

Laura Giraud-KerlerouxChloé CharpentierCharlotte BernigaudNicolas OrtonneCamille HuaSophie GaudronQuang Tuan Rémy NguyenOlivier ChosidowPierre WolkensteinSaskia Ingen-Housz-Oro
Published in: Journal of burn care & research : official publication of the American Burn Association (2022)
Thermal burns can occur during seizure. This diagnosis can be difficult in case of atypical lesions, even more if the epilepsy is unknown and in case of seizures with loss of consciousness and/or an unwitnessed epileptic attack. We report two cases of cutaneous bullous lesions initially misdiagnosed as severe acute cutaneous adverse reactions (generalized bullous fixed drug eruption and Stevens-Johnson syndrome). In the two cases, the clinical aspect, necrotic evolution, and absence of obvious attributable medication allowed to revert to the diagnosis of burns due to boiling water revealing previously unknown epilepsy. For both, surgical management with skin graft was performed, and antiepileptic treatment was introduced. Facing unexplained burns, occult epilepsy should be investigated. Questioning of patient and relatives is crucial.
Keyphrases
  • temporal lobe epilepsy
  • case report
  • adverse drug
  • healthcare
  • emergency department
  • mass spectrometry
  • high resolution
  • combination therapy
  • electronic health record
  • high speed