Terbinafine-induced generalized pustular psoriasis treated with dapsone

We report the case of a 37-year-old healthy woman who developed a generalized cutaneous eruption 1 week after starting oral terbinafine. The eruption was nonspecific, composed of erythematous—violaceous patches, limited areas of epidermal detachment, and sparse sterile pustules. Initial differential...

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Bibliographic Details
Main Authors: Matilde Monteiro, Joana F. Matos, André Coelho, Catarina Queirós
Format: Article
Language:English
Published: Sociedade Portuguesa de Dermatologia e Venereologia 2025-04-01
Series:Revista da Sociedade Portuguesa de Dermatologia e Venereologia
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Online Access:https://www.portuguesejournalofdermatology.com/frame_eng.php?id=216
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Summary:We report the case of a 37-year-old healthy woman who developed a generalized cutaneous eruption 1 week after starting oral terbinafine. The eruption was nonspecific, composed of erythematous—violaceous patches, limited areas of epidermal detachment, and sparse sterile pustules. Initial differential diagnoses included Stevens—Johnson Syndrome (SJS) and Acute Generalized Exanthematous Pustulosis (AGEP). Systemic corticosteroid therapy was initiated, with no improvement after 2 weeks. Skin biopsies suggested a diagnosis of pustular psoriasis,and during hospitalization, the patient developed scalyplaques on her scalp, more in keeping with terbinafine-induced Generalized Pustular Psoriasis (GPP). The patient was started on cyclosporine, which proved ineffective, followed by oral dapsone, which led toa major improvement within just 2 days. This case highlights the difficulty of differentiating between SJS, AGEP, and GPP in the presence of a nonspecific drug eruption and suggests dapsone as a safe therapeutic alternative for GPP.
ISSN:2182-2395
2182-2409