Terbinafine
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Pityriasis rosea and annular pustular psoriasis: case report A 25-year-old woman developed pityriasis rosea and annular pustular psoriasis during treatment with terbinafine for superficial dermatophytosis. The woman, who had a history of psoriasis vulgaris localised on the knees and elbows and superficial dermatophytosis, had been receiving treatment with oral terbinafine [dosage not stated]. However, 14 days after starting terbinafine, she developed and presented with an itchy rash. The lesions first started on the chest and then progressed all over the body without fever. Upon examination, multiple papules and plaques with elevated borders and collarettes of fine scaling, which were localised mainly over the trunk were observed. Whereas, other examinations were normal. She was also having severe itching and inflammatory lesions. Based on these findings, drug-induced pityriasis rosea was suspected. A skin biopsy confirmed the diagnosis of pityriasis rosea (Naranjo Adverse Drug Probability Scale was probable 6) along with keratinocyte necrosis with dermal oedema and perivascular inflammatory infiltrate made up of lymphocytes, histiocytes and eosinophils. The woman stopped receiving terbinafine and was treated with unspecified topical steroids. After a few days of stopping terbinafine, skin rash resolved. After 2 weeks, she developed generalised erythematous annular plaques and pustules all over the extremities and trunk. Additionally, she also presented with generalised small groups of pustules coalesced to form annular lakes on the trunk and extremities along with palmoplantar desquamation and facial erythema. The histological analysis of a second skin biopsy revealed intraepidermal pustules with spongiform pustules consisting of neutrophils and psoriasiform acanthosis. Based on these findings, a diagnosis of annular pustular psoriasis induced by terbinafine was made. Therefore, she was treated with unspecified topical steroids in combination with unspecified vitamin-D analogues. In 3 weeks, a complete remission was observed. Ben Salah N, et al. Case of generalized annular pustular psoriasis that has progressed from terbinafine-induced pityriasis rosea-like eruption. Dermatologic Therapy : 11 Nov 803520890 2020. Available from: URL: http://doi.org/10.1111/dth.14533
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Reactions 12 Dec 2020 No. 1834
