1
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Liu C, Zhou LL. Terbinafin-induzierte generalisierte pustulöse Psoriasis (GPP) vom Typ Zumbusch, die eine toxische epidermale Nekrolyse (TEN) simulierte: Terbinafine-induced generalized pustular psoriasis (GPP) of von Zumbusch simulating toxic epidermal necrolysis (TEN). J Dtsch Dermatol Ges 2024; 22:289-291. [PMID: 38361202 DOI: 10.1111/ddg.15301_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/02/2023] [Indexed: 02/17/2024]
Affiliation(s)
- Chaocheng Liu
- Abteilung für Dermatologie und Hautwissenschaft, Universität von British Columbia, Vancouver, BC, Kanada
| | - Linghong Linda Zhou
- Abteilung für Dermatologie und Hautwissenschaft, Universität von British Columbia, Vancouver, BC, Kanada
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2
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Liu C, Zhou LL. Terbinafine-induced generalized pustular psoriasis (GPP) of von Zumbusch simulating toxic epidermal necrolysis (TEN). J Dtsch Dermatol Ges 2024; 22:289-291. [PMID: 38161232 DOI: 10.1111/ddg.15301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/02/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Chaocheng Liu
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Linghong Linda Zhou
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, BC, Canada
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3
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de Oliveira GV, Maia MLP, Leão FAA, Sad EF, Silva MR, Ramos-E-Silva M. What to expect when AGEP is induced by terbinafine? case report and critical review of the literature. Mycoses 2022; 65:918-925. [PMID: 35876217 DOI: 10.1111/myc.13506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Acute Generalized Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or sub corneal non-follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury and allergens. OBJECTIVES AND METHODS We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and Sars-COV Vaccine. A detailed review of terbinafine-induced-AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A pubmed search helped retrieve all terbinafine induced AGEP case reports. AGEP specific Sideroff criteria were analyzed in Terbinafine-induced cases, and compared to other trigger causes. CONCLUSIONS when AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin during several weeks after exposure, even after discontinuation, and the disease severity may be potentialized by additional factors such as concomitant viral infections or vaccination.
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Affiliation(s)
- Gisele Viana de Oliveira
- Luxemburgo Hospital, Instituto Mario Penna.,GREMCIQ- Group for Multicenter studies on Hypertrophic scars and Keloids/ GV Dermatology- Des. Jorge Fontana 476-802 BH, MG, Brazil
| | | | | | | | | | - Marcia Ramos-E-Silva
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.,GREMCIQ- Group for Multicenter studies on Hypertrophic scars and Keloids/ GV Dermatology- Des. Jorge Fontana 476-802 BH, MG, Brazil
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4
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Kara Polat A, Alpsoy E, Kalkan G, Aytekin S, Uçmak D, Yasak Güner R, Topkarcı Z, Yılmaz O, Emre S, Borlu M, Türkoğlu Z, Özkök Akbulut T, Özaydın Yavuz G, Kaya Erdoğan H, Adışen E, Satılmış A, Oğuz Topal İ, Yazıcı S, Yılmaz E, Koku Aksu AE, Kartal SP, Deveci BN, Öksüm Solak E, Karadağ AS, Sarıkaya Solak S, Altunay İK, Türel Ermertcan A, Özkesici Kurt B, Kaçar NG, Ataseven A. Sociodemographic, Clinical, Laboratory, Treatment, and Prognostic Characteristics of 156 Generalized Pustular Psoriasis Patients in Turkey: A multicenter case series. J Eur Acad Dermatol Venereol 2022; 36:1256-1265. [DOI: 10.1111/jdv.18103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Asude Kara Polat
- University of Health Sciences Istanbul Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Erkan Alpsoy
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Göknur Kalkan
- Ankara Yıldırım Beyazıt University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Sema Aytekin
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Derya Uçmak
- Dicle University Faculty of Medicine Department of Dermatology Diyarbakır Turkey
| | - Rukiye Yasak Güner
- Sivas Cumhuriyet University Faculty of Medicine Department of Dermatology Sivas Turkey
| | - Zeynep Topkarcı
- University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Oğuz Yılmaz
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Selma Emre
- Ankara Yıldırım Beyazıt University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Murat Borlu
- Erciyes University Faculty of Medicine Department of Dermatology Kayseri Turkey
| | - Zafer Türkoğlu
- Başakşehir Çam and Sakura City Hospital Department of Dermatology Istanbul Turkey
| | - Tuğba Özkök Akbulut
- University of Health Sciences Haseki Training and Research Hospital Department of Dermatology Istanbul Turkey
| | | | - Hilal Kaya Erdoğan
- Eskişehir Osmangazi University Faculty of Medicine Department of Dermatology Eskişehir Turkey
| | - Esra Adışen
- Gazi University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - Ayşegül Satılmış
- Gazi University Faculty of Medicine Department of Dermatology Ankara Turkey
| | - İlteriş Oğuz Topal
- Prof. Dr. Cemil Taşcıoğlu City Hospital Department of Dermatology Istanbul Turkey
| | - Serkan Yazıcı
- Uludağ University Faculty of Medicine Department of Dermatology Bursa Turkey
| | - Ertan Yılmaz
- Akdeniz University Faculty of Medicine Department of Dermatology Antalya Turkey
| | - Ayşe Esra Koku Aksu
- University of Health Sciences Istanbul Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Selda Pelin Kartal
- University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital Department of Dermatology Ankara Turkey
| | - Beyza Nur Deveci
- University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital Department of Dermatology Ankara Turkey
| | - Eda Öksüm Solak
- Erciyes University Faculty of Medicine Department of Dermatology Kayseri Turkey
| | | | | | - İlknur Kıvanç Altunay
- University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital Department of Dermatology Istanbul Turkey
| | - Aylin Türel Ermertcan
- Manisa Celal Bayar University Faculty of Medicine Department of Dermatology Manisa Turkey
| | - Birgül Özkesici Kurt
- Adıyaman University Training and Research Hospital Department of Dermatology Adıyaman Turkey
| | - Nida Gelincik Kaçar
- Pamukkale University Faculty of Medicine Department of Dermatology Denizli Turkey
| | - Arzu Ataseven
- Necmettin Erbakan University Meram Faculty of Medicine Department of Dermatology Konya Turkey
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5
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Uppala R, Tsoi LC, Harms PW, Wang B, Billi AC, Maverakis E, Michelle Kahlenberg J, Ward NL, Gudjonsson JE. "Autoinflammatory psoriasis"-genetics and biology of pustular psoriasis. Cell Mol Immunol 2020; 18:307-317. [PMID: 32814870 DOI: 10.1038/s41423-020-0519-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition that has a fairly wide range of clinical presentations. Plaque psoriasis, which is the most common manifestation of psoriasis, is located on one end of the spectrum, dominated by adaptive immune responses, whereas the rarer pustular psoriasis lies on the opposite end, dominated by innate and autoinflammatory immune responses. In recent years, genetic studies have identified six genetic variants that predispose to pustular psoriasis, and these have highlighted the role of IL-36 cytokines as central to pustular psoriasis pathogenesis. In this review, we discuss the presentation and clinical subtypes of pustular psoriasis, contribution of genetic predisposing variants, critical role of the IL-36 family of cytokines in disease pathophysiology, and treatment perspectives for pustular psoriasis. We further outline the application of appropriate mouse models for the study of pustular psoriasis and address the outstanding questions and issues related to our understanding of the mechanisms involved in pustular psoriasis.
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Affiliation(s)
- Ranjitha Uppala
- Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, USA.,Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA. .,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA.
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6
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Ly K, Beck KM, Smith MP, Thibodeaux Q, Bhutani T. Diagnosis and screening of patients with generalized pustular psoriasis. PSORIASIS-TARGETS AND THERAPY 2019; 9:37-42. [PMID: 31417859 PMCID: PMC6592018 DOI: 10.2147/ptt.s181808] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/01/2019] [Indexed: 12/21/2022]
Abstract
Generalized pustular psoriasis (GPP) is a rare and potentially life-threatening variant of psoriasis that is characterized by recurrent, acute onset, widely distributed pustular eruptions on inflamed, erythematous skin. It is important to recognize acute GPP as a subtype of psoriasis associated with high morbidity and mortality so therapy can be initiated without delay. Since GPP was first described in 1910 by Leopold von Zumbusch, it has been inconsistently defined, stratified, and diagnosed in the literature. Multiple definitions and diagnostic criteria have been proposed over the years. Recently, formal consensus guidelines on GPP have been published by international groups. This article reviews the current evidence and understanding in the diagnosis and screening of GPP.
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Affiliation(s)
- Karen Ly
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Kristen M Beck
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Mary P Smith
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Quinn Thibodeaux
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, CA, USA
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7
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Boehner A, Navarini AA, Eyerich K. Generalized pustular psoriasis - a model disease for specific targeted immunotherapy, systematic review. Exp Dermatol 2018; 27:1067-1077. [DOI: 10.1111/exd.13699] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Alexander Boehner
- Department of Dermatology and Allergy Biederstein; Technical University of Munich; Munich Germany
| | | | - Kilian Eyerich
- Department of Dermatology and Allergy Biederstein; Technical University of Munich; Munich Germany
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8
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Hoegler K, John A, Handler M, Schwartz R. Generalized pustular psoriasis: a review and update on treatment. J Eur Acad Dermatol Venereol 2018; 32:1645-1651. [DOI: 10.1111/jdv.14949] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/06/2018] [Indexed: 01/19/2023]
Affiliation(s)
- K.M. Hoegler
- Department of Dermatology; Rutgers-New Jersey Medical School; Newark NJ USA
| | - A.M. John
- Department of Dermatology; Rutgers-New Jersey Medical School; Newark NJ USA
| | - M.Z. Handler
- Department of Dermatology; Rutgers-New Jersey Medical School; Newark NJ USA
| | - R.A. Schwartz
- Department of Dermatology; Rutgers-New Jersey Medical School; Newark NJ USA
- Rutgers University School of Public Affairs and Administration; Newark NJ USA
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9
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Koch A, Tchernev G, Wollina U. Allergic Maculo-Papular Exanthema Due To Terbinafine. Open Access Maced J Med Sci 2017; 5:535-536. [PMID: 28785353 PMCID: PMC5535678 DOI: 10.3889/oamjms.2017.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 11/05/2022] Open
Abstract
We report on a 76-year-old male patient who developed a maculopapular generalised exanthema due to terbinafine. Prick test was negative; patch test revealed a positive reaction after 48 h confirming the delayed-type allergic reaction. Non-pustular exanthema has only rarely been reported for terbinafine.
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Affiliation(s)
- André Koch
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany
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10
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Mayser P. [Terbinafine : Drug-induced lupus erythematodes and triggering of psoriatic skin lesions]. Hautarzt 2017; 67:724-31. [PMID: 27455869 DOI: 10.1007/s00105-016-3844-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Based on the technical information that oral terbinafine must be used with caution in patients with pre-existing psoriasis or lupus erythematosus, the literature was summarized. Terbinafine belongs to the drugs able to induce subcutaneous lupus erythematosus (SCLE)-with a relatively high risk. The clinical picture of terbinafine-induced SCLE may be highly variable and can also include erythema exsudativum multiforme-like or bullous lesions. Thus, differentiation of terbinafine-induced Stevens-Johnson syndrome or toxic epidermal necrolysis may be difficult. Therefore, terbinafine should be prescribed with caution in patients who show light sensitivity, arthralgias, positive antinuclear antibodies or have a history of SLE or SCLE. Case reports include wide-spread, but mostly nonlife-threatening courses, which did not require systemic therapy with steroids or antimalarials in every case. Terbinafine is also able to induce or to aggravate psoriasis. The latency period seems to be rather short (<4 weeks). Terbinafine therefore is not first choice if a systemic therapy with antimycotics is indicated in a patient with psoriasis or psoriatic diathesis. Azole derivatives according to the guidelines may be used as an alternative.
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Affiliation(s)
- P Mayser
- , Hofmannstr. 11, 35444, Biebertal, Deutschland.
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11
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Benjegerdes KE, Hyde K, Kivelevitch D, Mansouri B. Pustular psoriasis: pathophysiology and current treatment perspectives. PSORIASIS (AUCKLAND, N.Z.) 2016; 6:131-144. [PMID: 29387600 PMCID: PMC5683122 DOI: 10.2147/ptt.s98954] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Psoriasis vulgaris is a chronic inflammatory disease that classically affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes of psoriasis including the uncommon pustular variants, which are subdivided into generalized and localized forms. Generalized forms of pustular psoriasis include acute generalized pustular psoriasis, pustular psoriasis of pregnancy, and infantile and juvenile pustular psoriasis. Localized forms include acrodermatitis continua of Hallopeau and palmoplantar pustular psoriasis. These subtypes vary in their presentations, but all have similar histopathologic characteristics. The immunopathogenesis of each entity remains to be fully elucidated and some debate exists as to whether these inflammatory pustular dermatoses should be classified as entities distinct from psoriasis vulgaris. Due to the rarity of these conditions and the questionable link to the common, plaque-type psoriasis, numerous therapies have shown variable results and most entities remain difficult to treat. With increasing knowledge of the pathogenesis of these variants of pustular psoriasis, the development and use of biologic and other immunomodulatory therapies holds promise for the future of successfully treating pustular variants of psoriasis.
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Affiliation(s)
| | - Kimberly Hyde
- Texas A&M Health Science Center College of Medicine, Round Rock
| | | | - Bobbak Mansouri
- Texas A&M Health Science Center College of Medicine, Temple
- Department of Dermatology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine, Temple, TX, USA
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12
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Abstract
Drug-induced lichen planus has been induced by antibiotics, anticonvulsants, antidiabetics, antimalarials, antitubercular drugs, antihypertensives, psychiatric drugs, chemotherapeutic agents, diuretic, heavy metals, NSAIDs, etc. Terbinafine, an antifungal agent, is widely used for dermatophyte infections and onychomycosis. Cutaneous adverse effects of terbinafine are rarely reported. Here, we report a case of terbinafine-induced lichenoid drug eruption in a 22-year-old who presented with generalized lichenoid eruption 2 weeks after terbinafine initiation of. The body and lip cleared completely after 8 weeks of drug withdrawal; nail change cleared after 12 weeks.
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Affiliation(s)
- Yue Zheng
- a Department of Dermatovenereology , the Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou, Guangdong , P.R. China and
| | - Jie Zhang
- a Department of Dermatovenereology , the Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou, Guangdong , P.R. China and
| | - Haiyan Chen
- a Department of Dermatovenereology , the Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou, Guangdong , P.R. China and
| | - Wei Lai
- a Department of Dermatovenereology , the Third Affiliated Hospital of Sun Yat-Sen University , Guangzhou, Guangdong , P.R. China and
| | - Howard I Maibach
- b Department of Dermatology , University of California, School of Medicine , San Fransico, CA, USA
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13
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Varman KM, Namias N, Schulman CI, Pizano LR. Acute generalized pustular psoriasis, von Zumbusch type, treated in the burn unit. A review of clinical features and new therapeutics. Burns 2014; 40:e35-9. [PMID: 24491419 DOI: 10.1016/j.burns.2014.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 01/06/2014] [Indexed: 12/19/2022]
Abstract
Generalized pustular psoriasis (GPP) is an immune-mediated dermatologic condition that is characterized by a widespread eruption of sterile, subcorneal pustules. Cases of GPP may present to the burn intensive care unit (ICU), and they may be confused with toxic epidermal necrolysis (TEN) due to the generalized erythema and desquamation. GPP often benefits from admission to an ICU for management of fluid and electrolyte imbalances and for complications such as pneumonitis, renal dysfunction and sepsis. We present the case of a 42 year-old man who was transferred to the burn unit for presumed TEN where he was diagnosed with GPP and successfully treated with intravenous cyclosporine and supportive care. Our objective is to increase awareness of this condition in the critical care community, discuss clinical and laboratory findings, and to review the treatment guidelines published by the National Psoriasis Foundation in August 2012. We also discuss the latest reports utilizing biological response modifying drugs.
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Affiliation(s)
- Katherine M Varman
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
| | - Nicholas Namias
- Division of Trauma, Surgical Critical Care and Burns/University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carl I Schulman
- Division of Trauma, Surgical Critical Care and Burns/University of Miami Miller School of Medicine, Miami, FL, USA
| | - Louis R Pizano
- Division of Trauma, Surgical Critical Care and Burns/University of Miami Miller School of Medicine, PO Box 016960 (D-40), Miami 33101, FL, USA.
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