Has Topimax (topiramate) been reported to cause folliculitis in the vulvae?/nA woman is treated wit

Fråga: Has Topimax (topiramate) been reported to cause folliculitis in the vulvae?

A woman is treated with topiramate due to epilepsy. She has twice experienced folliculitis not only in the vulva but also in the face.

Sammanfattning: Nothing has been found in the literature of folliculitis during treatment with topiramate. However, it has been reported to occur in 1.3 per cent of treated patients (n=1715) in unpublished material from the manufacturer. In the present case, a relationship to treatment seems possible.

Svar: Topiramate is a new drug for treatment of adults with epilepsy. It is a sulphamate-substituted monosaccharide and structurally distinct from other antiepileptic drugs. It probably works by blocking voltage-activated sodium channels, increasing synaptic levels of the gamma aminobuturic acid (GABA) (1,2).

The most common reported side-effects are CNS-related effects such as dizziness, fatigue, drowsiness, impaired concentration, confusion, ataxia and paraesthesia (2).

Folliculitis secondary to drug treatment has been reported for corticosteroids and lithium (3) but also in connection to cyclosporin A (4). Folliculitis caused by Pseudomonas aeruginosa has been increasing due to the popularity of hot tubs and whirlpools. Some cases occurring in women after epilation of the legs.

Nothing has been found in the literature concerning folliculitis and the use of topiramate. However, one case has been reported to the WHO centre in Uppsala, no further information is known concerning this case.

Folliculitis is mentioned among less common side-effects to topiramate in Fass (5).

In unpublished material of 1715 patients, 22 cases of folliculitis were seen (1.3 per cent)(6). At the time when the report was compiled, the symptoms had resolved in 18 of the cases and in 4 cases the progress was unknown. It was not known in what parts of the body these folliculitis had appeared.