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- W2289422403 abstract "Terbinafine is an antifungal agent that is effective for the oral treatment of dermatophytes. Herein, we report a rare case of terbinafine induced erythema multiforme (EM) associated with hepatitis. A 59-year-old woman was admitted with a generalized targetoid, pruritic eruption. Terbinafine for onychomycosis was started three weeks earlier. Clinical signs and skin biopsy were consistent with EM. Laboratory investigations showed liver dysfunction with elevated liver enzyme activities. Diagnostic tests for viral and autoimmune hepatitis were negative. Other well established causes of EM were ruled out. Terbinafine induced EM with hepatitis was suspected, the antifungal was stopped and oral corticosteroid treatment was started. Patient’s condition improved dramatically and liver tests returned to normal. EM is an acute mucocutaneous hypersensitivity reaction with variety of etiologies. It is characterized by a skin eruption, with or without mucous membrane lesions. It can be induced by drug intake or several infections. Terbinafine is generally well tolerated and the most common cutaneous adverse effects are rash, pruritus and urticaria. In the literature a few cases of EM have been reported following exposure to this drug. It had also reported that patients who have developed EM during terbinafine treatment suffered from a systemic autoimmune disease and no hepatic disorder was associated to the skin manifestation. Our case was diagnosed to be a suspected case of drug-induced EM with hepatitis on the basis of drug history, clinical presentation, improvement with dechallenge and exclusion of other likely causes of EM and hepatitis. According to the Naranjo probability scale, the adverse drug reaction was considered probable. Clinicians should be aware of the risk of EM associated with terbinafine, a generally well tolerated drug. The skin involvement may be also associated with liver disorder." @default.
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- W2289422403 date "2015-08-01" @default.
- W2289422403 modified "2023-10-18" @default.
- W2289422403 title "Terbinafine induced Erythema multiforme with Hepatitis" @default.
- W2289422403 doi "https://doi.org/10.1016/j.clinthera.2015.05.263" @default.
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