RESUMO
Acute generalized exanthematous pustulosis (AGEP) is a clinical reaction pattern characterized by the rapid appearance of widespread sterile, nonfollicular pustules arising within edematous erythematous skin. This aseptic pustular eruption is commonly accompanied by leukocytosis and fever and usually follows recent administration of oral or parenteral drugs. We report two cases of terbinafine-induced AGEP in male patients. Both patients developed a generalized erythroderma with scaling and pruritic pustules 7 and 14 days following initiation of oral terbinafine. With immediate discontinuation of terbinafine and various treatment protocols, both patients demonstrated recovery followed by skin desquamation during the subsequent weeks. Terbinafine is the most frequently used systemic antimycotic and antifungal medication, reflecting its superior efficacy for dermatophyte infections. Despite the appealing drug profile, an awareness of terbinafine-induced AGEP is important given the 5 percent mortality associated with AGEP. Additionally, distinguishing the characteristics of AGEP from those associated with toxic epidermal necrolysis, Stevens-Johnson syndrome, and generalized pustular psoriasis allows for prompt dermatologic evaluation, accurate diagnosis, and appropriate treatment.
Assuntos
Pustulose Exantematosa Aguda Generalizada/induzido quimicamente , Antifúngicos/efeitos adversos , Toxidermias/etiologia , Naftalenos/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/tratamento farmacológico , Administração Oral , Adulto , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Humanos , Masculino , Naftalenos/administração & dosagem , Naftalenos/uso terapêutico , Onicomicose/tratamento farmacológico , TerbinafinaRESUMO
Annular atrophic lichen planus (AALP) is a rare variant of lichen planus. The clinical presentation of AALP shows distinct atrophic plaques with elevated borders on the trunk and extremities. Histopathologic findings generally reveal a lichenoid dermatitis in active lesions with a distinct loss of elastic fibers in the center of the lesions. We report a unique case of AALP, which highlights the chronicity of the eruption. Our patient showed early signs of improvement with hydroxychloroquine and acitretin, suggesting a role for systemic therapy in the treatment of AALP.