Question

The patient is undergoing treatment for lupus erythematosus and requires the addition of an antifungal drug. The primary health care provider decides to avoid use of which of the following a. ketoconazole b. fluconazole c. nystatin d. terbinafine

Answer 1

Ans) d. Terbinafine

Explaination:

- Skin lesions, located on the trunk, and upper and lower extremities. Despite severe skin lesions, patients revealed good response to topical corticosteroids within a few weeks. The systemic review of the literature and our experience on terbinafine-induced SCLE developing in patients with SLE allowed to create a description for this special subset:

a) terbinafine-induced SCLE usually develop in 1-8 weeks after terbinafine introduction,

b) skin lesions are usually severe, disseminated including lower extremities,

c) patients present Ro/SS-A La/SS-B antibodies, but anti-histone antibodies are rarely observed,

d) exacerbation of SLE symptoms is rather not observed,

e) eruptions clear within 2-8 weeks,

f) withdrawal of terbinafine and topical corticosteroids should be considered as a first-line therapy in these cases,

g) terbinafine should be carefully used in patients suffering from SLE.