BACKGROUND: The severe adverse cutaneous reactions of erythema multiforme (EM), 
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare 
mucocutaneous diseases associated with significant morbidity and mortality. The 
most common cause is antiepileptic drugs, particularly carbamazepine and 
lamotrigine, as well as the barbiturates group (phenobarbital and phenytoin). In 
this article, we present seven children with severe adverse cutaneous reactions 
caused by barbiturates.
CASE REPORTS: The age of the affected children was between 2 and 11 years and 
they all had a history of taking barbiturates. Their symptoms started 1-3 weeks 
after the initiation of barbiturates, including a prodrome characterized by 2-3 
days of malaise, fever, cough and anorexia, after which the skin and mucosal 
lesions appeared and worsened. The skin lesions varied from rash to large 
bullae, plus different forms of mucous membrane involvement. The offending drugs 
(barbiturates) were stopped immediately and care was largely supportive.
CONCLUSION: As a result of the morbidity and/or mortality associated with EM, 
SJS and TEN, physicians should keep in mind their differential diagnosis when 
cutaneous reactions are observed in patients undergoing barbiturate therapy. 
Furthermore, although TEN and SJS are life-threatening diseases, early detection 
and appropriate care can lead to a decrease in the incidence of death. The 
strategies described here seem to be successful and safe because, despite the 
serious conditions, our patients responded well. All survived.