Acute generalized exanthematous pustulosis induced by the antifungal terbinafine: case report and review of the literature.
Cutaneous drug reactions occur with a frequency of 1-8% and can be higher for certain classes of drugs. They can range from mild morbilliform eruptions to more severe forms such as drug-hypersensitivity syndrome, toxic epidermal necrolysis or anaphylaxis. Acute generalized exanthematous pustulosis (AGEP) is considered to be a clinical reaction pattern, which is induced in over 90% of the cases by systemic drugs. It is a rare presentation of an adverse drug reaction most frequently triggered by anti-infectious drugs. A high proportion of these cases have been attributed to aminopenicillins and macrolides. We report a terbinafine-induced AGEP in a 68-year-old male confirmed by lymphocyte stimulation in vitro, and review the published cases induced by antimycotic drugs with special emphasis on terbinafine-triggered cases.
Beltraminelli
H S
HS
Department of Dermatology, Kantonsspital Basel, University of Basel, Petersgraben 4 CH-4031 Basel, Switzerland. hbeltraminelli@uhbs.ch
Lerch
M
M
Arnold
A
A
Bircher
A J
AJ
Haeusermann
P
P
D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005076:Exanthema / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D009281:Naphthalenes / Q000008:administration & dosage / Q000009:adverse effects*; D014009:Onychomycosis / Q000188:drug therapy; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D000077291:Terbinafine
D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine