Early-stage mycosis fungoides, parapsoriasis en plaque, and pregnancy.

BACKGROUND: Non-Hodgkin's lymphoma (NHL) coincident with pregnancy is rare, and the literature regarding mycosis fungoides (MF), the most common primary cutaneous NHL, and pregnancy is strikingly sparse. The effect of pregnancy on MF, or on parapsoriasis en plaque (PPP), and the effect of these diseases on pregnancy, are still unknown. OBJECTIVE: To study the effect of pregnancy on MF and PPP and the impact of these diseases on pregnancy. METHODS: The files of the MF and PPP patients seen during the past 12 years in our department were reviewed to search for patients who had been pregnant during the course of their disease. RESULTS: Nine women who met the study criteria were identified, seven with early-stage MF and two with PPP. A total of 12 pregnancies was recorded: nine in patients with MF and three in patients with PPP. In none of the patients was there any indication that pregnancy changed the course of MF or PPP. Of the 12 pregnancies, 11 were normal; one was naturally aborted. Two of the patients were treated with topical steroids during pregnancy. One patient was treated with narrow-band ultraviolet-B combined with topical steroids. The rest preferred to avoid any therapy. CONCLUSIONS: Pregnancy appeared to have no impact on the course of early MF or PPP, and no adverse effect was noted on pregnancy. Further studies are needed to clarify the interplay between pregnancy and MF or PPP.

[Subacute cutaneous lupus erythematosus induced by terbinafine].

BACKGROUND: 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. CASE: 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. CONCLUSIONS: 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.