J Korean Med Sci.  2007 Feb;22(1):167-169. 10.3346/jkms.2007.22.1.167.

Generalized Pustular Psoriasis and Hepatic Dysfunction Associated with Oral Terbinafine Therapy

• Kim BS
• Jang HS
• Jwa SW
• Jang BS
• Kim MB
• Oh CK
• Kwon YW
• Kwon KS

• KMID: 1713261
• DOI: http://doi.org/10.3346/jkms.2007.22.1.167

Abstract

We report a case of 61-yr-old man with stable psoriasis who progressively developed generalized pustular eruption, erythroderma, fever, and hepatic dysfunction following oral terbinafine. Skin biopsy was compatible with pustular psoriasis. After discontinuation of terbinafine and initiating topical corticosteroid and calcipotriol combination with narrow band ultraviolet B therapy, patient's condition slowly improved until complete remission was reached 2 weeks later. The diagnosis of generalized pustular psoriasis (GPP) induced by oral terbinafine was made. To our knowledge, this is the first report of GPP accompanied by hepatic dysfunction associated with oral terbinafine therapy.

Keyword

Psoriasis; Generalized Pustular Psoriasis; Liver Diseases; terbinafine

MeSH Terms

Suppuration/chemically induced
Psoriasis/*chemically induced
Naphthalenes/*adverse effects
Middle Aged
Male
Liver Diseases/*chemically induced
Humans
Antifungal Agents/*adverse effects
Administration, Oral

Figure

• 

  Fig. 1 (A) Generalized erythema covered with tiny pustules and scalings. (B) Close-up view of pustules on erythematous background.

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  Fig. 2 Subcorneal spongiform pustules with psoriasiform hyperplasia (hematoxylin-eosion stain, ×40).

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