Coexisting subacute and systemic lupus erythematosus after terbinafine administration: successful treatment with mycophenolate mofetil.
A 39-year-old female patient with systemic lupus erythematosus was treated with terbinafine for onychomycosis. After only 7 days of treatment with 250 mg terbinafine, a widespread severe erythematous eruption developed. The results of clinical, histological and immunofluorescent examinations confirmed the diagnosis of coexisting subacute and systemic lupus erythematosus. The patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone. One year later, mycophenolate mofetil was successfully used. Exacerbation or induction of lupus erythematosus is an extremely rare cutaneous side-effect of terbinafine. Patients with lupus erythematosus should be advised about the risk of some drugs that might exacerbate their disease.
Department of Dermatology, Charles University Hospital, Pilsen, The Czech Republic. cetkovska@fnplzen.cz
Petra
P
Cetkovská
Karel
K
Pizinger
D000208:Acute Disease; D000328:Adult; D000935:Antifungal Agents / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009281:Naphthalenes / Q000009:adverse effects*; D014009:Onychomycosis / Q000150:complications / Q000188:drug therapy; D000077291:Terbinafine
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D009281:Naphthalenes; D016572:Cyclosporine; D000077291:Terbinafine; D009173:Mycophenolic Acid; D008775:Methylprednisolone