ABSTRACT
Patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex are subject to exaggerated clinical expression of infectious diseases. Widespread keratotic papules and striking hyperkeratosis of the palms and soles went unrecognized as a manifestation of tuberculosis, thereby delaying treatment in a patient with AIDS-related complex. Reliance on special stains from skin or lymph nodes to diagnose tuberculosis is inappropriate because organisms may not be detected and culture of the organism from the skin may be difficult.
Subject(s)
AIDS-Related Complex/complications , Keratoderma, Palmoplantar/complications , Tuberculosis, Cutaneous/complications , Adult , Diagnosis, Differential , Drug Therapy, Combination , Humans , Keratoderma, Palmoplantar/pathology , Keratosis/complications , Keratosis/pathology , Male , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Cutaneous/pathologyABSTRACT
Terbinafine is an allylamine antifungal agent widely used to treat dermatophyte onychomycosis and dermatomycoses. We report 10 severe cutaneous adverse reactions associated with terbinafine therapy which required discontinuation of the antifungal agent: erythema multiforme (five patients), erythroderma (one), severe urticaria (one), pityriasis rosea (one) and worsening of pre-existing psoriasis (two patients). The spectrum of cutaneous adverse effects associated with terbinafine therapy is reviewed. Patients should be counselled about discontinuing terbinafine at the onset of a cutaneous eruption and about seeking medical advice about further management.