title: [Terbinafine : Drug-induced lupus erythematodes and triggering of psoriatic skin lesions].
abstract: Based on the technical information that oral terbinafine must be used with caution in patients with pre-existing psoriasis or lupus erythematosus, the literature was summarized. Terbinafine belongs to the drugs able to induce subcutaneous lupus erythematosus (SCLE)-with a relatively high risk. The clinical picture of terbinafine-induced SCLE may be highly variable and can also include erythema exsudativum multiforme-like or bullous lesions. Thus, differentiation of terbinafine-induced Stevens-Johnson syndrome or toxic epidermal necrolysis may be difficult. Therefore, terbinafine should be prescribed with caution in patients who show light sensitivity, arthralgias, positive antinuclear antibodies or have a history of SLE or SCLE. Case reports include wide-spread, but mostly nonlife-threatening courses, which did not require systemic therapy with steroids or antimalarials in every case. Terbinafine is also able to induce or to aggravate psoriasis. The latency period seems to be rather short (<4 weeks). Terbinafine therefore is not first choice if a systemic therapy with antimycotics is indicated in a patient with psoriasis or psoriatic diathesis. Azole derivatives according to the guidelines may be used as an alternative.
authors.affiliation: , Hofmannstr. 11, 35444, Biebertal, Deutschland. peter.mayser@derma.med.uni-giessen.de.
authors.forename: P
authors.initials: P
authors.lastname: Mayser
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D009281:Naphthalenes / Q000009:adverse effects*; D011565:Psoriasis / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D000077291:Terbinafine; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine
keywords: Acute generalized exanthematous pustulosis; Antifungal agents; Erythema multiforme; Light sensitivity; Psoriasis