Terbinafine-induced subacute cutaneous lupus erythematosus.
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.


METHODS
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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Farhi
David
D
Department of Dermatology 1, Saint Louis Hospital, Paris, France.
Viguier
Manuelle
M
Cosnes
Anne
A
Reygagne
Pascal
P
Dubertret
Louis
L
Revuz
Jean
J
Roujeau
Jean-Claude
JC
Bachelez
Hervé
H
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000097:blood / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects* / Q000627:therapeutic use; D014009:Onychomycosis / Q000188:drug therapy; D000077291:Terbinafine
D000974:Antibodies, Antinuclear; D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine