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• W4251416615 abstract "A 74-year-old woman was admitted to the hospital with an acute pruritic, generalized pustular eruption after 5 days of terbinafine therapy for tinea cruris. The patient had a generalized symmetric erythematous pustular rash affecting initially the inguinal folds and then spreading to the body with prominent localization in the main folds (Figs 1 and 2). Fig. 2Erythematous eruption covered with superficial nonfollicular pustules.View Large Image Figure ViewerDownload Hi-res image Download (PPT)General symptoms were fever (38°C) and hypertension (220/100 mm Hg). Abnormal laboratory investigations included a total white blood cell count of 17,220 cells/mm3 (80% neutrophils) and slight hypoalbuminemia (3.17 g/dL). Cultures of the pustules were negative. Histology demonstrated subcorneal spongiform microabscesses, papillary edema, and polymorphous perivascular infiltrates with eosinophils. Terbinafine was discontinued and pustules resolved within 5 weeks after treatment with methylprednisolone (0.6 mg/kg). Patch tests performed with terbinafine were negative. No recurrence has been observed during a 3-year follow-up period. In 1980, Beylot introduced the term acute generalized exanthematous pustulosis to describe a pathologic entity characterized by acute onset, no history of psoriasis, spontaneous resolution, and histopathologic finding of dermal vasculitis with nonfollicular subcorneal pustules. Several reports described this rash as an adverse drug reaction, cutaneous manifestation of viral infection, or hypersensitivity to mercury. During terbinafine therapy, systemic adverse reactions may occur in 7.7% of patients and include hepatitis, agranulocytosis, uveitis, green vision, taste disturbance, and olfactory disorders. Skin manifestations may occur in 2.7% of patients and include toxic epidermal necrolysis, erythema toxicum, fixed drug eruption, erythema annulare centrifugum-like eruption, Stevens-Johnson syndrome, subacute cutaneous lupus erythematosus, and psoriasis, also of pustular type. There are 5 reports of acute generalized exanthematous pustulosis induced by terbinafine.1Kempinaire A De Raeve L Merckx M De Coninck A Bauwens M Roseeuw D. Terbinafine-induced acute generalized exanthematous pustulosis confirmed by a positive patch-test result.J Am Acad Dermatol. 1997; 37: 653-655Abstract Full Text Full Text PDF PubMed Scopus (55) Google Scholar, 2Dupin N Gorin I Djien V Helal H Zylberberg L Leibowitch M et al.Acute generalized exanthematous pustulosis induced by terbinafine.Arch Dermatol. 1996; 132: 1253-1254Crossref PubMed Scopus (35) Google Scholar, 3Condon CA Downs AMR Archer CB. Terbinafine induced acute generalized exanthematous pustulosis.Br J Dermatol. 1998; 138: 709-710Crossref PubMed Scopus (35) Google Scholar, 4Rogalski C Hurlimann A Burg G Wuthrich B Kempf W. Drug reaction to terbinafine simulating an acute generalized exanthematous pustulosis.Hautarzt. 2001; 52: 444-448Crossref PubMed Scopus (19) Google Scholar, 5Hall AP Tate B. Acute generalized exanthematous pustulosis associated with oral terbinafine.Australas J Dermatol. 2000; 41: 42-45Crossref PubMed Scopus (34) Google Scholar In the case noted, the disease duration was longer than in other cases with different drugs. We believe that the long-lasting time is the result of the pharmacokinetics of terbinafine that may be found in stratum corneum 48 days, and in nails 90 days, after the last day of medication." @default.
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• W4251416615 date "2003-07-01" @default.
• W4251416615 modified "2023-09-26" @default.
• W4251416615 title "Acute generalized exanthematous pustulosis induced by terbinafine" @default.
• W4251416615 doi "https://doi.org/10.1016/s0190-9622(03)70101-7" @default.
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