Acute Generalized Exanthematous Pustulosis Caused by Terbinafine / 대한피부과학회지

ABSTRACT

A 12-year-old girl visited our clinic with pruritic non-follicular pustules on reddish bases and scales on her face, trunk, and proximal extremities. She complained of fever and chills. Before she was admitted to our clinic, she had been treated with terbinafine (125 mg/day) for tinea corporis. Three days after beginning the terbinafine treatment, whitish pustules on erythematous bases occurred abruptly in the intertriginous areas. A physical examination showed that the girl's body temperature was 38degrees C. Laboratory investigations revealed neutrophil-dominant leukocytosis. A skin biopsy specimen taken from a pustular lesion on the trunk revealed subcorneal pustules. The papillary dermis was edematous, and a superficial perivascular lymphocytic infiltrate with scattered interstitial neutrophils was noted. She was diagnosed as having acute generalized exanthematous pustulosis because of terbinafine use on the basis of her history, and clinical and histopathological findings. Her terbinafine treatment was discontinued promptly, and systemic corticosteroids and antihistamines were administered and topical corticosteroids were applied. Three days later, the skin lesions and constitutional symptoms had improved and there has been no recurrence to date.