Farhi David, Viguier Manuelle, Cosnes Anne, Reygagne Pascal, Dubertret Louis, Revuz Jean, Roujeau Jean-Claude, Bachelez Hervé
Department of Dermatology 1, Saint Louis Hospital, Paris, France.
Dermatology. 2006;212(1):59-65. doi: 10.1159/000089024.
Nearly 10% of lupus erythematosus (LE) are drug induced. More than 60 different drugs are involved in iatrogenic LE. We report herein 3 cases of terbinafine-induced LE.
Three patients receiving terbinafine for a suspected dermatophytic infection developed a subacute cutaneous LE, within 7 weeks following terbinafine introduction. The patients' medical history included sicca syndrome, lung carcinoma and Kikuchi disease, respectively. Clinical remission occurred within 15 weeks following terbinafine withdrawal.
Sixteen cases of terbinafine-induced LE have been previously reported, including 13 women. The median age was 54 years. Prior autoimmunity was reported in 10 cases, including 5 pre-existing LE. The median delay between terbinafine introduction and LE onset was 5 weeks. The median time until clinical recovery following terbinafine withdrawal was 8 weeks.
Terbinafine should be prescribed only in patients with proven dermatophytosis. We recommend cautious monitoring in patients with pre-existing autoimmunity. The diagnosis of terbinafine-induced LE should lead to the immediate and definitive withdrawal of the drug.
近10%的红斑狼疮（LE）是药物诱发的。超过60种不同药物与医源性LE有关。我们在此报告3例特比萘芬诱发的LE。
3例因疑似皮肤癣菌感染而接受特比萘芬治疗的患者，在使用特比萘芬后7周内出现亚急性皮肤型LE。患者的病史分别包括干燥综合征、肺癌和菊池病。停用特比萘芬后15周内临床症状缓解。
此前已报告16例特比萘芬诱发的LE，其中包括13名女性。中位年龄为54岁。10例报告有既往自身免疫性疾病，其中5例为原有LE。从开始使用特比萘芬到发生LE的中位间隔时间为5周。停用特比萘芬后至临床恢复的中位时间为8周。
特比萘芬仅应开具给确诊为皮肤癣菌病的患者。我们建议对有既往自身免疫性疾病的患者进行密切监测。诊断为特比萘芬诱发的LE后应立即彻底停药。
