Bonsmann G, Schiller M, Luger T A, Ständer S
Department of Dermatology, University of Münster, Germany.
J Am Acad Dermatol. 2001 Jun;44(6):925-31. doi: 10.1067/mjd.2001.114565.
Recently, the induction of subacute cutaneous lupus erythematosus (SCLE) and exacerbation of systemic lupus erythematosus by terbinafine have been reported.
We describe 4 cases of SCLE, one associated with chilblain lupus, which occurred during therapy with oral terbinafine for onychomycosis.
Of 21 consecutive patients with SCLE attending the outpatient dermatology department at Muenster University clinic during a 1-year period, 4 patients with terbinafine-induced SCLE were seen. Patients were examined fully and photographed; histologic findings as well as serologic and follow-up data were evaluated.
In addition to high titers of antinuclear antibodies (ANA) with a homogeneous pattern, anti-Ro(SS-A) antibodies were present; in 3 of 4 women, anti-La(SS-B) antibodies were also found. All patients had anti-histone antibodies as in drug-induced lupus and showed the characteristic genetic association of SCLE with the HLA-B8,DR3 haplotype; moreover, in 2 cases, HLA-DR2 was also present. After discontinuation of terbinafine, ANA titers decreased; anti-histone antibodies also became undetectable within 4(1/2) months in 3 patients concomitant with subsidence of the SCLE eruption in all patients.
Terbinafine is a drug that appears to infrequently induce SCLE with high titers of ANAs and anti-histone antibodies in genetically susceptible persons.
最近，已有报告称特比萘芬可诱发亚急性皮肤型红斑狼疮（SCLE）并加重系统性红斑狼疮。
我们描述了4例SCLE病例，其中1例与冻疮样狼疮相关，这些病例发生在口服特比萘芬治疗甲癣的过程中。
在明斯特大学诊所皮肤科门诊1年期间连续就诊的21例SCLE患者中，发现了4例由特比萘芬诱发的SCLE患者。对患者进行了全面检查并拍照；评估了组织学结果以及血清学和随访数据。
除了高滴度的均质型抗核抗体（ANA）外，还存在抗Ro（SS-A）抗体；在4名女性中的3名中，还发现了抗La（SS-B）抗体。所有患者均有药物性狼疮中出现的抗组蛋白抗体，并显示出SCLE与HLA-B8、DR3单倍型的特征性遗传关联；此外，在2例患者中还存在HLA-DR2。停用特比萘芬后，ANA滴度下降；3例患者在4（1/2）个月内抗组蛋白抗体也变得无法检测到，同时所有患者的SCLE皮疹消退。
特比萘芬是一种似乎在遗传易感人群中很少诱发高滴度ANA和抗组蛋白抗体的SCLE的药物。
