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Hyperplasia of the gums and hirsutism can occur. Hypersensitivity reactions, usually skin rashes, are quite common while hepatitis, which can be severe and lymph node enlargement are less common. Increased incidence of fetal malformation, particularly cleft palate and cardiac malformation is suspected in epileptic mothers who take phenytoin. Carbamazepine appears to have similar pharmacological action to phenytoin. It is particularly useful in treating psychomotor epilepsy. It induces liver enzymes, which reduces its effectiveness and the effectiveness of other drugs such as phenytoin, oral contraceptives, warfarin and corticosteroids.
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Keratinocytes of the epidermis are arranged into four or five layers. The deepest layer is the stratum basale, which is a single layer of dividing cells.
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