Papuloerythroderma like Eruption Triggered by Terbinafine

Abstract

Papuloerythroderma of Ofuji is an enigmatic entity. It is commonly idiopathic; at times, it may occur secondary to atopy, infections, malignancies or drugs. We report a patient who developed the characteristic generalized itchy eruption of confluent cobblestone-like papules, sparing the flexures, a few days after he was put on terbinafine, empirically, for suspected dermatophytosis. Other associated features included relative lymphopenia and dermatopathic lymphadenopathy. The rash responded to withdrawal of terbinafine and treatment with systemic corticosteroids. Terbinafine has a wide range of cutaneous adverse effects, but this is the first report of terbinafine-associated papuloerythroderma. We would like to bring to notice this important, though rare side effect, of a commonly used drug.