Generalized pustular eruptions due to terbinafine

Öztürk, Gökçen Kartal; Türk, Bengü Gerçeker; Karaca, Nezih; Karaarslan, Isil; Ertekin, Banu; Ertam, İlgen; Kazandi, Ali Can; Kandıloğlu, Gülşen

doi:10.3109/15569527.2011.607202

Cited by 20 publications

(17 citation statements)

References 15 publications

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“…Other reports associate the withdrawal of cyclosporine with a GPP flare . Considering the administration of drugs, a variety of different medications have been associated with GPP, like treatment with antibiotics (amoxicillin, penicillin), antihypertensives (propranolol, ramipril), paradoxical reactions with biologics such as anti‐TNF‐α and ustekinumab, PEGylated interferon, bupropion and terbinafin . However, since distinguishing AGEP, a pustular‐type drug eruption and a common differential diagnosis of GPP, from GPP can be extremely difficult, new administration of drugs associated with the onset of GPP should be regarded with caution.…”

Section: Resultsmentioning

confidence: 99%

Generalized pustular psoriasis – a model disease for specific targeted immunotherapy, systematic review

Boehner

Navarini

Eyerich

2018

Experimental Dermatology

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Generalized pustular psoriasis (GPP) is a rare, multisystemic skin disease characterized by recurrent episodes of pustulation. GPP can be life-threatening and is often difficult to treat. In the era of precision medicine in dermatology, GPP stands exemplary for both challenges and chances-while new treatments offer great hope, there is urgent need for better definition and stratification of this severe and heterogeneous disease. Our objective was to systematically review the literature for evidence of efficacy of targeted immunotherapy and their mode of action in the context of clinical phenotype, classification and pathogenesis of adult GPP. Classifying GPP is challenging since clinical criteria for description and diagnosis are not consistent between expert centres. We therefore defined diagnostic feasibility of the reviewed cases by assessing four criteria: compatible clinical history, typical dermatological features and/or diagnostic histopathology, consistent clinical pictures and the DITRA status. Pathogenesis of GPP is mediated by pathways that partly overlap plaque type psoriasis, with a more pronounced activity of the innate immune system. Both IL-1 and IL-36 but also IL-17 play a major role in disease formation. We ascertained a total of 101 published cases according to our predefined criteria and identified TNF-α, IL-12/23, IL-17 and IL-1β as targets for immunotherapy for the treatment of GPP. Of those cases, 61% showed complete response and 27% partial response to targeted immunotherapy. Only 12% experienced weak or no response. These data indicate that specific immunotherapy can be used to effectively treat GPP, with most evidence existing for anti-IL-17 agents.

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Section: Resultsmentioning

confidence: 99%

Generalized pustular psoriasis – a model disease for specific targeted immunotherapy, systematic review

Boehner

Navarini

Eyerich

2018

Experimental Dermatology

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“…The aetiology of pustular psoriasis is uncertain. Its onset has been linked with medications, including terbinafine, ramipril, rituximab, clopidogrel, amoxicillin, topical calcipotriol and steroid combinations, NSAIDs, aspirin, sulphonamides, lithium, morphine, topical coal tar, potassium iodide, progestins and hydroxychloroquine . TNF‐alpha inhibitors have been associated with paradoxical pustular flares, possibly due to a cytokine imbalance that allows interferon‐alpha to be activated in an unopposed fashion .…”

Section: Aetiologymentioning

confidence: 99%

Generalized pustular psoriasis: a review and update on treatment

Hoegler

John

Handler

et al. 2018

Acad Dermatol Venereol

160

193

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Generalized pustular psoriasis (GPP) is a subtype of pustular psoriasis characterized by painful and occasionally disfiguring cutaneous manifestations with sepsis-like systemic symptoms. Affecting any age and race, GPP can occur with other forms of psoriasis or by itself. Stimuli for flares include medications, infections and environmental triggers. The interleukin family and caspase recruitment domain family have been implicated in its pathogenesis. Other forms of pustular psoriasis include impetigo herpetiformis, palmoplantar pustular psoriasis, annular pustular psoriasis and acrodermatitis continua of Hallopeau. Treatment is not well established, but includes the use of retinoids, methotrexate, cyclosporine, corticosteroids, TNF-alpha inhibitors, topical therapy and phototherapy. The use of TNF-alpha inhibitors may result in the formation of antidrug antibodies and should be administered with methotrexate.

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“… 25 , 26 Other drugs, such as terbinafine and methotrexate, may also serve as triggers for acute GPP as a form of drug-specific allergic reactions, which can often be confirmed with patch tests. 12 , 27 …”

Section: Generalized Pustular Psoriasismentioning

confidence: 99%

Pustular psoriasis: pathophysiology and current treatment perspectives

Benjegerdes¹,

Hyde²,

Kivelevitch³

et al. 2016

PTT

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Psoriasis vulgaris is a chronic inflammatory disease that classically affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes of psoriasis including the uncommon pustular variants, which are subdivided into generalized and localized forms. Generalized forms of pustular psoriasis include acute generalized pustular psoriasis, pustular psoriasis of pregnancy, and infantile and juvenile pustular psoriasis. Localized forms include acrodermatitis continua of Hallopeau and palmoplantar pustular psoriasis. These subtypes vary in their presentations, but all have similar histopathologic characteristics. The immunopathogenesis of each entity remains to be fully elucidated and some debate exists as to whether these inflammatory pustular dermatoses should be classified as entities distinct from psoriasis vulgaris. Due to the rarity of these conditions and the questionable link to the common, plaque-type psoriasis, numerous therapies have shown variable results and most entities remain difficult to treat. With increasing knowledge of the pathogenesis of these variants of pustular psoriasis, the development and use of biologic and other immunomodulatory therapies holds promise for the future of successfully treating pustular variants of psoriasis.

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Generalized pustular eruptions due to terbinafine

Cited by 20 publications

References 15 publications

Generalized pustular psoriasis – a model disease for specific targeted immunotherapy, systematic review

Generalized pustular psoriasis – a model disease for specific targeted immunotherapy, systematic review

Generalized pustular psoriasis: a review and update on treatment

Pustular psoriasis: pathophysiology and current treatment perspectives

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