Acute generalized terbinafine

Acute generalized exanthematous pustulosis associated with terbinafine has been described in two patients (47,49). Both presented within 7-10 days after starting to take terbinafine with generalized pustular dermatosis and leukocytosis fever was a presenting symptom in one patient. Treatment with systemic corticosteroids was successful in both cases. 

In another case of acute generalized exanthematous pustulosis attributed to terbinafine (250 mg/day), epicutaneous and intracutaneous skin tests were negative, and there was no evidence of viral infection (51). 

Condon CA, Downs AM, Archer CB. Terbinafine-induced acute generalized exanthematous pustulosis. Br J Dermatol 1998 138(4) 709-10. 

Kempinaire A, De Raeve L, Merckx M, De Coninck A, Bauwens M, Roseeuw D. Terbinafine-induced acute generalized exanthematous pustulosis confirmed by a positive patch-test result. J Am Acad Dermatol 1997 37(4) 653-5. 

Acute generalized exanthematous pustulosis (AGEP) has been attributed to various drugs in the same patient, including terbinafine [2 ]. 

A 79-year-old woman took terbinafine for intertrigo and 2 weeks later she developed widespread erythema over the trunk with superficial pustules. The erythema intensified, the pustules became confluent and spread all over her body, and she had a fever and a leukocytosis. Liver function tests, urea and creatinine were normal. Biopsy showed acute generalized exanthematous pustulosis (AGEPX Terbinafine was withdrawn and the eruption subsided gradually over the next 10 days. Eight years later she again... 

A further case of acute generalized exanthematous pustulosis associated with oral terbinafine has been reported it was refractory to oral glucocorticoids but responsive to high-dose intravenous glucocorticoids [3 ]. 

Eyler JT, Squires S, Fraga GR, Liu D, Kestenbaum T. Two cases of acute generalized exanthematous pustulosis related to oral terbinafine and an analysis of the clinical reaction pattern. Dermatol Online J 2012 18(11) 5. 

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