Subacute Cutaneous Lupus Erythematosus Induced or Exacerbated by Terbinafine

Callen, Jeffrey P.; Hughes, Amy P.; Kulp‐Shorten, Carol L.

doi:10.1001/archderm.137.9.1196

Cited by 88 publications

(43 citation statements)

References 10 publications

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“…Although our patients had a strong background predisposition for LE, reports in the literature include patients with no history of cutaneous or systemic LE developing drug induced LE specific lesions. 7 It has been reported that the incidence of lichenoid drug eruptions is significantly higher among dermatomyositis patients relative to LE patients, 29 although this has not been the experience of the senior author (RDS). The reason for this is unclear, one contributing factor may be the tendency for drug reactions causing basal layer apoptosis to progress to LE specific lesions rather than typical lichenoid drug reactions, in the LE predisposed patient.…”

Section: Discussionmentioning

confidence: 99%

Antimalarial lichenoid tissue reactions in patients with pre-existing lupus erythematosus

Geraminejad

Stone

Sontheimer

2004

Lupus

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Recently a number of cases of drug induction or exacerbation of lupus erythematosus (LE) specific skin disease have been described in the literature. Many of the responsible medications are also known for their ability to induce a lichenoid tissue reaction. Aminoquinoline antimalarials are currently the first line of therapy in cutaneous LE specific skin disease. Lichenoid tissue reactions are among the most common cutaneous side effects of aminoquinolone antimalarials. We report three cases of aminoquinolone antimalarial induced or exacerbated LE specific skin disease. We also review the pathophysiology of LE specific skin disease and propose a mechanism by which induction of the lichenoid tissue reaction may result in Koebnerization of LE specific skin lesions.

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Section: Discussionmentioning

confidence: 99%

Antimalarial lichenoid tissue reactions in patients with pre-existing lupus erythematosus

Geraminejad

Stone

Sontheimer

2004

Lupus

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“…Benign side effects are observed in about 10% of patients, usually affecting the digestive tract and the skin (ageusia, nausea, diarrhea, erythema, pruritus, urticaria), occurring in 4.9 and 2.3% of patients, respectively [19, 20]. In rare cases, there have been reports of hepatitis, severe hematological abnormalities, and serious cutaneous side effects have been reported, such as bullous pemphigoid [21], acute generalized exanthematous pustulosis [22,23,24], toxic epidermal necrolysis [25, 26], hypersensitivity reaction (‘DRESS syndrome’) [27], erythema multiforme [26, 28], pustular psoriasis [29] or SCLE [11,12,13,14,15,16,17]. …”

Section: Discussionmentioning

confidence: 99%

“…Sixteen cases of terbinafine-induced LE have been previously reported (tables 1, 2) [11,12,13,14,15,16,17]. Thirteen patients were women (sex ratio F/M: 4.3).…”

Section: Discussionmentioning

confidence: 99%

“…The SCLE variety of terbinafine-induced LE was most commonly observed (n = 13; 81 %), including 10 de novo SCLE and 3 SCLE-like eruptions in patients with previously known SLE, 2 of them having already experienced SCLE flare-ups induced by other drugs, such as captopril or hydrochlorothiazide [15]. One case of de novo SCLE was associated with chilblain lupus [14].…”

Section: Discussionmentioning

confidence: 99%

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Terbinafine-Induced Subacute Cutaneous Lupus Erythematosus

Farhi¹,

Viguier²,

Cosnes

et al. 2006

Dermatology

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Background: Nearly 10% of lupus erythematosus (LE) are drug induced. More than 60 different drugs are involved in iatrogenic LE. We report herein 3 cases of terbinafine-induced LE. Observations: Three patients receiving terbinafine for a suspected dermatophytic infection developed a subacute cutaneous LE, within 7 weeks following terbinafine introduction. The patients’ medical history included sicca syndrome, lung carcinoma and Kikuchi disease, respectively. Clinical remission occurred within 15 weeks following terbinafine withdrawal. Discussion: Sixteen cases of terbinafine-induced LE have been previously reported, including 13 women. The median age was 54 years. Prior autoimmunity was reported in 10 cases, including 5 pre-existing LE. The median delay between terbinafine introduction and LE onset was 5 weeks. The median time until clinical recovery following terbinafine withdrawal was 8 weeks. Conclusion: Terbinafine should be prescribed only in patients with proven dermatophytosis. We recommend cautious monitoring in patients with pre-existing autoimmunity. The diagnosis of terbinafine-induced LE should lead to the immediate and definitive withdrawal of the drug.

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“…Nine published cases of drug-induced SCLE have been related to use of oral terbinafine [22,24]. As with SCLE associated with hydrochlorothiazide, the clinical and serologic profile of terbinafine-induced SCLE is comparable to primary idiopathic SCLE.…”

Section: Drug-induced Subacute Lupus (Scle)mentioning

confidence: 99%

Skin manifestations of drug reactions

Rosso

2002

Curr Allergy Asthma Rep

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Dermatologic manifestations of adverse drug reactions are commonly encountered in both hospital-based and ambulatory medical practice. Diagnosis is confounded by the myriad clinical presentations associated with cutaneous drug eruptions. Some presentations are highly characteristic, while others are not as straightforward, and may simulate other primary dermatoses. In many cases, patients are utilizing several medications and an obvious temporal relationship to a specific drug is not always apparent or expressed by the patient during disclosure of his or her medical history. A thorough medication history and a high index of suspicion are very important components in the diagnosis of drug eruptions.

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Subacute Cutaneous Lupus Erythematosus Induced or Exacerbated by Terbinafine

Cited by 88 publications

References 10 publications

Antimalarial lichenoid tissue reactions in patients with pre-existing lupus erythematosus

Antimalarial lichenoid tissue reactions in patients with pre-existing lupus erythematosus

Terbinafine-Induced Subacute Cutaneous Lupus Erythematosus

Skin manifestations of drug reactions

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