[Subacute cutaneous lupus erythematosus induced by terbinafine]

The onset of subacute cutaneous lupus erythematosus (SCLE) may be associated with the administration of a variety of drugs. Terbinafine, an oral antifungal agent, which rarely causes cutaneous eruptions, has been implicated as the cause or exacerbation of cutaneous lupus erythematosus in several patients.

A 59-year-old man had received oral terbinafine for onychomycosis. The patient had a history of SCLE, which was in complete remission during the last 5 years. A month after initiating treatment with terbinafine the patient developed SCLE, which was diagnosed clinically and by histology. He had typical papulosquamous lesions. Immunological studies showed elevated titers of anti-nuclear antibodies. Following discontinuation of terbinafine therapy and under the treatment of systemic and topical steroids, a slow resolution of the eruption was noted over several weeks.

This report, along with previous cases described, suggests the association between terbinafine therapy and the onset or exacerbation of SCLE often occurring in a patient with history of systemic lupus erythematosus or SCLE.