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Oral Antifungal Therapy: Emerging Culprits of Cutaneous Adverse Drug Reactions

Raju G Chaudhary1, Santoshdev P Rathod1, Ashish Jagati1

  • 1Department of Dermatology, N.H.L. Medical College, Ahmedabad, Gujarat, India.

Indian Dermatology Online Journal
|April 16, 2019
PubMed
Abstract

Insights

Oral antifungals are widely used for dermatophytosis but can cause cutaneous adverse drug reactions (CADRs). Terbinafine was the most frequent cause, highlighting the need to consider systemic antifungals in CADR cases.

Area of Science:

  • Dermatology
  • Pharmacovigilance
  • Mycology

Background:

  • Oral antifungals are common in treating dermatophytosis.
  • While generally safe, oral antifungals can cause cutaneous adverse drug reactions (CADRs).
  • Uncommon morphological patterns of CADRs have been increasingly reported.

Purpose of the Study:

  • To report cases of CADRs associated with oral antifungal therapy.
  • To determine the incidence of CADRs in patients receiving oral antifungals.
  • To identify the specific antifungal agents most frequently implicated in CADRs.

Main Methods:

  • An observational, prospective study was conducted over 4 months at a tertiary care center.
  • Patients with superficial dermatophytic infections receiving oral antifungal therapy were included.
  • The incidence and clinical types of CADRs were calculated.

Main Results:

  • The incidence of CADRs was 8.3 per 10,000 patients.
  • 35 cases of CADRs were reported among 4,208 dermatophytosis cases.
  • Terbinafine (83%) was the most common causative agent, followed by itraconazole (14%) and griseofulvin (2.8%).

Conclusions:

  • Systemic antifungals should be considered in patients presenting with CADRs.
  • CADRs associated with oral antifungals warrant attention as a potential trend.
  • Monitoring and reporting of these reactions are crucial for patient safety.
Keywords:
Cutaneous adverse drug reactionsgeneric drugslupus erythematosus-like reactionoral antifungals

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