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[Colestasic toxic hepatitis caused by terbinafine: case report]
Zuño Burstein1, Herman Vildósola, Zenaida Lozano
1Servicio de Dermatología Sanitaria, Instituto de Medicina Tropical Daniel A. Carrión, UNMSM.
Summary
Systemic antifungal therapy offers a cure for trichophytic toenail fungus. However, this case report highlights potential severe liver side effects from terbinafine, emphasizing the need for careful patient monitoring.
Area of Science:
- Dermatology
- Hepatology
- Pharmacology
Background:
- Trichophytic onychomycosis of the feet is a significant medical issue.
- Systemic antifungal therapy, particularly since the 1950s, has provided effective treatment options.
- The widespread dissemination of these agents necessitates a review of their adverse effects.
Observation:
- A young, healthy patient developed severe toxic cholestatic hepatitis after six weeks of terbinafine treatment (250 mg/day) for toenail onychomycosis.
- Pertinent testing confirmed the diagnosis of drug-induced liver injury.
- The patient recovered fully after discontinuing the medication, with no apparent long-term sequelae.
Findings:
- Terbinafine, a commonly used antifungal, can cause severe hepatotoxicity.
- Close monitoring of hepatic function is crucial before and during treatment with terbinafine.
- This case underscores the importance of pharmacovigilance for systemic antifungal drugs.
Implications:
- Healthcare providers should be vigilant regarding potential liver toxicity associated with terbinafine.
- Further research is needed to identify ideal antifungal agents with improved safety profiles.
- This study contributes to the understanding of adverse drug reactions in onychomycosis treatment.