Terbinafine induced pityriasis rosea-like eruption

Abstract

Terbinafine is an allylamine antifungal agent which is widely used for the treatment of fungal infections. Cutaneous side effects have been reported in 2% of the patients on terbinafine therapy with many morphological patterns. We report a case of terbinafine induced pityriasis rosea, a very rare side effect of terbinafine. This report emphasizes the importance of counseling the patient to report immediately in the event of a cutaneous eruption.

Typical antimicrobials induce mast cell degranulation and anaphylactoid reactions via MRGPRX2 and its murine homologue MRGPRB2

“…For example, acrylamide antimicrobials are antifungal drugs , aminoglycosides are especially effective against infections with members of the Enterobacteriaceae and Staphylococcus aureus and sulfonamides are broad‐spectrum antimicrobials . A large number of reports on clinical adverse reactions indicate that acrylamides, represented by terbinafine hydrochloride, can cause serious cutaneous side effects, such as pityriasis rosea . Aminoglycosides, such as sisomicin hydrochloride can lead to systemic contact dermatitis , while sulfa drugs, such as sulfamethoxazole, have been shown to cause hypersensitivity reactions in the treatment of children with brucellosis .…”

Case of generalized annular pustular psoriasis that has progressed from terbinafine‐induced pityriasis rosea‐like eruption

“…[2][3][4] Nevertheless, there were only three reported cases of pityriasis rosea-like eruption associated with terbinafine. 1 The literature review suggests that the latency periods between the administration of terbinafine and the exacerbation or de novo appearance of psoriasis is categorized as "short" (less than 4 weeks), as in our case. 3 Terbinafine-induced AGEP has been reported in psoriatic patients.…”

“…reported in 2% of patients treated with terbinafine. 1 We report an atypical case of terbinafine-induced pityriasis rosea-like eruption followed by induced annular pustular psoriasis.…”

Reply: Commentary on letter to the editor from Drago et al

“… 2 Unfortunately, we did not evaluate our patient for the presence of HHV-6/7 serum antibodies or plasma DNA during the acute phase of the eruption. 3 , 4 , 5 , 6 Regarding peripheral eosinophilia, our patient had transient eosinophilia with absolute eosinophil count of 880. The presence of eosinophilia might support a drug-induced eruption; however, most of the PR-like eruptions present with normal eosinophil count.…”