Terbinafine therapy may be associated with the development of psoriasis de novo or its exacerbation: four case reports and a review of drug-induced psoriasis.
ABSTRACT Adverse effects may occur in 10.4% of patients receiving terbinafine therapy, with cutaneous reactions in 2.7%. We describe the development of psoriasis in four patients who took oral terbinafine. Two patients had plaque-type psoriasis that flared 12 and 17 days, respectively, after starting terbinafine. Another patient developed pustular-type psoriasis de novo after 27 days of terbinafine therapy. The fourth patient was a psoriatic with stable plaque disease who experienced a pustular flare after taking terbinafine for 21 days. We are aware of only one report in the literature in which a patient developed pustular psoriasis de novo after 5 days of terbinafine therapy. In all patients the psoriasis cleared or lessened after discontinuation of terbinafine and institution of antipsoriatic therapy.
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ABSTRACT: The antifungal agent terbinafine has been approved for marketing in The Netherlands since 1992. Adverse drug reactions (ADRs) may occur in about 10% of the patients, the majority gastrointestinal disorders and skin reactions. Since the introduction of terbinafine, the Netherlands Pharmacovigilance Foundation Lareb received eight reports of arthralgia during the use of this drug. In four reports the additional presence of skin reactions was mentioned, two of these reports concerned urticaria. Two patients who reported arthralgia also had a fever. These reports were described in more detail, and analysed statistically in order to determine whether symptoms are interrelated. All reports with known gender and a reporting date between 1 March 1992 and 1 January 1999, concerning patients older than 10 years, were included. The extent to which the symptoms urticaria, fever and arthralgia were interrelated was examined by logistic regression modelling. Case series as well as the results of the statistical analysis show a clustering of symptoms among reports of patients using terbinafine. Both urticaria and arthralgia were statistically significantly associated with reports on terbinafine compared to all other reports in the database. The findings might point towards a clustering of these symptoms in patients using terbinafine. Possibly these symptoms have a shared aetiology, presumably an immunological reaction.Pharmacoepidemiology and Drug Safety 03/2001; 10(2):135-42. DOI:10.1002/pds.581 · 3.17 Impact Factor
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ABSTRACT: Objective: The present study was undertaken to evaluate the frequency of fungal infections of the nails changed in the course of psoriasis and to provide an answer whether psoriatic nails are specially predisposed to fungal infections. Material and Methods: 83 psoriatic patients with nail changes participated in the study. Among them there were 25 females and 58 males, aged 18~76 years. 59 patients (71.1%) had psoriasis vulgaris, the remaining ones - 24 subjects (28.9%) suffered from arthropathic psoriasis. In any case of nail abnormalities clinically suspected of fungal infection the further mycological investigations were performed. Fungal infections were finally diagnosed on the base of direct microscopy and positive culture. The Chi2 test and the Mann-Whitney U-test were used for statistical analysis. Results: Positive mycological cultures were obtained from 15 patients (18%). The most commonly isolated fungi were moulds cultured in 6 patients (37%), followed by dermatophytes - 5 patients (31.5%) and yeast-like fungi - also 5 subjects (31.4%). Moulds and yeast-like fungi were found in both fingernails and toenails; all dermatophyte infections were diagnosed on the toenails. Psoriatic patients with fungal nail infections were older than those with negative mycological examination and the duration of psoriasis in this group of patients was also longer. Although the above differences between two studied groups were evident, they did not reach the statistical significance. Conclusions: Based on the achieved results it is difficult to assess definitely whether psoriasis is a predisposing factor to the development of fungal infections of the nails.
Article: Terbinafine: an update.[Show abstract] [Hide abstract]
ABSTRACT: Oral terbinafine was first introduced in the United Kingdom in February 1991 and was approved for the treatment of onychomycosis in the United States in May 1996. It is estimated that 4 million patients worldwide have been treated with oral terbinafine as of December 1996. The efficacy of terbinafine in the treatment of onychomycosis and other dermatomycoses is reviewed. The adverse-effects profile of oral terbinafine is evaluated.Journal of the American Academy of Dermatology 01/1998; 37(6):979-88. DOI:10.1016/S0190-9622(97)70076-8 · 5.00 Impact Factor