Subacute cutaneous lupus erythematosus induced by terbinafine: case report and review of literature

Lorentz, Katharina; Booken, Nina; Goerdt, Sergij; Goebeler, Matthias

doi:10.1111/j.1610-0387.2008.06806.x

Cited by 23 publications

(16 citation statements)

References 16 publications

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“…The underlying mechanisms are unclear but cutaneous adverse reactions are very common during treatment with terbinafine. Terbinafine is also a known photosensitizer and simultaneous involvement with Ro/SSA antibodies has been suggested 26,27 . Our four patients with SCLE with a prior exposure of terbinafine all had their exposure during the summer months, which would suggest a photosensitization mechanism.…”

Section: Discussionmentioning

confidence: 63%

Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden

Grönhagen

Fored

Linder

et al. 2012

British Journal of Dermatology

133

105

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We found an association between drug exposure and SCLE. More than one third of the SCLE cases could be attributed to drug exposure. No significant OR was found for thiazides, which might be due to longer latency and therefore missed with this study design. DI-SCLE is reversible once the drug is discontinued, indicating the importance of screening patients with SCLE for potentially triggering drugs. A causal relationship cannot be established from this study and the underlying pathogenesis remains unclear.

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Section: Discussionmentioning

confidence: 63%

Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden

Grönhagen

Fored

Linder

et al. 2012

British Journal of Dermatology

133

105

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“…The average incubation time for terbinafine, which made up 29 of the reported cases, was 5AE1 weeks. 11,12 The one case with griseofulvin had an incubation time of 2 weeks. 13 In recent reports, the chemotherapeutic drugs capecitabine and paclitaxel showed rapid onset (days in some cases).…”

Section: How Long Are the Incubation And Resolution Periods For Drug-mentioning

confidence: 99%

A systematic review of drug-induced subacute cutaneous lupus erythematosus

Rh³

et al. 2011

British Journal of Dermatology

139

266

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The initial appearance of subacute cutaneous lupus erythematosus (SCLE) skin lesions in conjunction with Ro/SS-A autoantibodies occurring as an adverse reaction to hydrochlorothiazide [i.e. drug-induced SCLE (DI-SCLE)] was first reported in 1985. Over the past decade an increasing number of drugs in different classes has been implicated as triggers for DI-SCLE. The management of DI-SCLE can be especially challenging in patients taking multiple medications capable of triggering DI-SCLE. Our objectives were to review the published English language literature on DI-SCLE and use the resulting summary data pool to address questions surrounding drug-induced SCLE and to develop guidelines that might be of value to clinicians in the diagnosis and management of DI-SCLE. A systematic review of the Medline/PubMed-cited literature on DI-SCLE up to August 2009 was performed. Our data collection and analysis strategies were prospectively designed to answer a series of questions related to the clinical, prognostic and pathogenetic significance of DI-SCLE. One hundred and seventeen cases of DI-SCLE were identified and reviewed. White women made up the large majority of cases, and the mean overall age was 58·0 years. Triggering drugs fell into a number of different classes, highlighted by antihypertensives and antifungals. Time intervals ('incubation period') between drug exposure and appearance of DI-SCLE varied greatly and were drug class dependent. Most cases of DI-SCLE spontaneously resolved within weeks of drug withdrawal. Ro/SS-A autoantibodies were present in 80% of the cases in which such data were reported and most remained positive after resolution of SCLE skin disease activity. No significant differences in the clinical, histopathological or immunopathological features between DI-SCLE and idiopathic SCLE were detected. There is now adequate published experience to suggest that DI-SCLE does not differ clinically, histopathologically or immunologically from idiopathic SCLE. It should be recognized as a distinct clinical constellation differing clinically and immunologically from the classical form of drug-induced systemic lupus erythematosus.

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“…The most commonly implicated drugs in subacute cutaneous DILE are antihypertensive agents, like thiazide diuretics and calcium channel blockers, and terbinafine [21]. Thiazides diuretics tend to have the longest incubation period ranging from six months to five years; for channel blockers the mean incubation period is 3.2 years, while for terbinafine it is just five weeks [18, 22]. Other drugs implicated are beta blockers, angiotensin‐converting enzyme inhibitors, antihistamines (ranitidine), immunomodulators (leflunomide and interferons), antiepileptics, statins, biologics (anti‐TNFα), proton pump inhibitors such as lansoprazole, omeprazole and pantoprazole [23] (Figure 2).…”

Section: Drug‐induced Sclementioning

confidence: 99%

Drug‐induced lupus erythematosus with emphasis on skin manifestations and the role of anti‐TNFα agents

Vedove

Simon

Girolomoni

2012

J Deutsche Derma Gesell

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Drug-induced lupus erythematosus (DILE) is a lupus-like syndrome temporally related to continuous drug exposure which resolves upon drug discontinuation. There are currently no standard diagnostic criteria for DILE. Findings include skin manifestations, arthritis, serositis, anti-nuclear and anti-histone antibodies positivity. Similarly to idiopathic lupus erythematosus, DILE can be divided into systemic (SLE), subacute cutaneous (SCLE) and chronic cutaneous lupus (CCLE). Systemic DILE presents as a milder version of idiopathic SLE, and the drugs most frequently implicated are hydralazine, procainamide and quinidine. Anti-TNFα therapies are the latest class of medications found to be associated, although rarely, with a “lupus-like” syndrome, which is however clinically distinct from classical DILE. Drug-induced SCLE is the most common form of DILE. It is very similar to idiopathic SCLE in terms of clinical and serologic characteristics. The most commonly implicated drugs are antihypertensive drugs and terbinafine, but in recent years also proton pump inhibitors and chemotherapeutic agents have been associated. Drug-induced CCLE is very rare and usually caused by fluorouracil agents and NSAIDS, but some cases have induced by pantoprazole and anti-TNFα agents.

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Subacute cutaneous lupus erythematosus induced by terbinafine: case report and review of literature

Cited by 23 publications

References 16 publications

Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden

Subacute cutaneous lupus erythematosus and its association with drugs: a population-based matched case-control study of 234 patients in Sweden

A systematic review of drug-induced subacute cutaneous lupus erythematosus

Drug‐induced lupus erythematosus with emphasis on skin manifestations and the role of anti‐TNFα agents

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