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Carbamazepine is known to potentially cause severe skin reactions, one of the most serious being Toxic Epidermal Necrolysis (TEN). TEN is characterized by widespread necrosis and exfoliation of the skin, leading to significant morbidity and mortality. Its onset can be linked to the administration of certain medications, including carbamazepine, particularly in individuals who may have genetic predispositions, such as specific HLA-B alleles, that increase the risk of such reactions.

The mechanisms by which carbamazepine induces TEN involve immune-mediated hypersensitivity reactions, leading to keratinocyte apoptosis. Patients taking carbamazepine should be closely monitored for any signs of dermatological reactions, especially during the initial phase of treatment.

In contrast, conditions like psoriasis, acne, and eczema are associated with different pathophysiological processes and are not typically induced by carbamazepine. Psoriasis is an immune-mediated inflammatory condition, acne is primarily driven by hormonal and bacterial factors, and eczema involves skin barrier dysfunction and allergic or irritant responses. Thus, these options are less relevant when discussing common dermatological reactions associated specifically with carbamazepine.