Systemic photoallergy to terbinafine

Table 1 Provocation cumulative dose, variation of total nasal resistance during the follow-up times, and symptoms in patient undergone metamizole challenge test R T0, nasal resistance at baseline; R T1, nasal resistance after the first dose.
Terbinafine is an allylamine antimycotic Accepted for publication 16 November 2009 1. Nettis E, Colanardi MC, Ferrannini A, Vacca A, Tursi A. Short-term tolerability of etoric- ated reaction. This hypothesis fits well oxib in patients with cutaneous hypersensitiv- (2–4). To the author’s knowledge, this is 2. Asero R. Detection of aspirin reactivity in disorders. Allergy 1998;53:214–215.
3. Clement PAR. Committee Report on stan- patients with urticaria following a single line: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy 2007;62: 5. An˜ı´barro B, Fontela JL. Immediate rhinocon- junctivitis induced by metamizole and metro- Zaffiro A, Di Sora F, Menzella F et al.
to progress on his face, de´collete´ and tions with allergic, nonallergic, or mixed 7. Himly M, Jahn-Schmid B, Pittertschatscher K, Bohle B, Grubmayr K, Ferreira F et al.
ing appeared in the preceding night.
Local and oral steroids led to a signifi- 8. Asero R. Oral aspirin challenges in patients with a history of intolerance to single non- steroidal anti-inflammatory drugs. Clin Exp Allergy 65 (2010) 1058–1072 ª 2010 John Wiley & Sons A/S prior to the present episode, he wasprescribed LamisilattTM cream(terbinafine hydrochloride 1%) forsome rash on his hands. He couldrecall that he had used the cream for1–2 weeks and this was in the summer.
It seems that this combination of apre-existing inflammatory skin condi-tion (disrupted skin barrier, danger sig-nals) with exposure to terbinafine andsolar irradiation might have createdcircumstances (formation of photoad-ducts) leading to the induction of hisphotoallergy.
Figure 1 Photopatch testing with a dilution series (1–25%) of terbinafine hydrochloride, dis- solved in liquid paraffin, water and ethanol, 96 h after application of the tests and 48 h after irradiation with 5 J/cm2 UVA. On the left-hand side (nonirradiated), no reaction to the same Accepted for publication 24 November 2009 able until collecting more experience.
scored as ICDRG ‘‘+’’ after 72 h of application to the skin (24 h after irra- 1. Roberts DT. Oral terbinafine (Lamisil) in the and ‘‘++’’ after 96 h (48 h after irra- treatment of fungal infections of the skin and nails. Dermatology 1997;1(Suppl. 1):37–39.
2. Murphy M, Barnes L. Terbinafine-induced for initial testing; however, the results 3. Brooke R, Coulson IH, al-Dawoud A.
Terbinafine-induced subacute cutaneous lupus 10 and 25% – all with ‘‘+’’ to ‘‘++’’ terbinafine. Br J Dermatol 1998;139:1133.
5. Spiewak R. Patch testing for contact allergy and allergic contact dermatitis. Open Allergy ‘‘condition’’ effector lymphocytes to exclude false-positive (phototoxic) reac- 6. Vocanson M, Hennino A, Rozieres A, Poyet G, Nicolas JF. Effector and regulatory mech- tests – all with negative results. Later anisms in allergic contact dermatitis. Allergy Allergy 65 (2010) 1058–1072 ª 2010 John Wiley & Sons A/S

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