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...

Full description

Saved in:
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
Subjects:
Online Access:https://www.portuguesejournalofdermatology.com/frame_eng.php?id=216
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849423229084499968
author Matilde Monteiro
Joana F. Matos
André Coelho
Catarina Queirós
author_facet Matilde Monteiro
Joana F. Matos
André Coelho
Catarina Queirós
author_sort Matilde Monteiro
collection DOAJ
description 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.
format Article
id doaj-art-2b48444307d242abb9df227803cd70fa
institution Kabale University
issn 2182-2395
2182-2409
language English
publishDate 2025-04-01
publisher Sociedade Portuguesa de Dermatologia e Venereologia
record_format Article
series Revista da Sociedade Portuguesa de Dermatologia e Venereologia
spelling doaj-art-2b48444307d242abb9df227803cd70fa2025-08-20T03:30:41ZengSociedade Portuguesa de Dermatologia e VenereologiaRevista da Sociedade Portuguesa de Dermatologia e Venereologia2182-23952182-24092025-04-01832Terbinafine-induced generalized pustular psoriasis treated with dapsoneMatilde Monteiro0Joana F. Matos1André Coelho2Catarina Queirós3Department of Dermatology, Unidade Local de Saúde de Gaia/Espinho, EPE, Porto, PortugalDepartment of Dermatology, Unidade Local de Saúde de Gaia/Espinho, EPE, Porto, PortugalDepartment of Pathological Anatomy. Centro Hospitalar Universitário de Santo António, Porto, PortugalServiço de Dermatologia, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, PortugalWe 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. https://www.portuguesejournalofdermatology.com/frame_eng.php?id=216Generalized pustular psoriasis. Drug eruption. Terbinafine. Dapsone.
spellingShingle Matilde Monteiro
Joana F. Matos
André Coelho
Catarina Queirós
Terbinafine-induced generalized pustular psoriasis treated with dapsone
Revista da Sociedade Portuguesa de Dermatologia e Venereologia
Generalized pustular psoriasis. Drug eruption. Terbinafine. Dapsone.
title Terbinafine-induced generalized pustular psoriasis treated with dapsone
title_full Terbinafine-induced generalized pustular psoriasis treated with dapsone
title_fullStr Terbinafine-induced generalized pustular psoriasis treated with dapsone
title_full_unstemmed Terbinafine-induced generalized pustular psoriasis treated with dapsone
title_short Terbinafine-induced generalized pustular psoriasis treated with dapsone
title_sort terbinafine induced generalized pustular psoriasis treated with dapsone
topic Generalized pustular psoriasis. Drug eruption. Terbinafine. Dapsone.
url https://www.portuguesejournalofdermatology.com/frame_eng.php?id=216
work_keys_str_mv AT matildemonteiro terbinafineinducedgeneralizedpustularpsoriasistreatedwithdapsone
AT joanafmatos terbinafineinducedgeneralizedpustularpsoriasistreatedwithdapsone
AT andrecoelho terbinafineinducedgeneralizedpustularpsoriasistreatedwithdapsone
AT catarinaqueiros terbinafineinducedgeneralizedpustularpsoriasistreatedwithdapsone