Oral terbinafine-induced planter pustular psoriasis.

Background. Cutaneous reactions may occur in patients receiving terbinafine therapy, mainly rash and urticaria. More exceptionally, development of pso riasis has been described. We describe the development of plantar pustular psoriasis in a patient who took oral terbinafine. Case report. A 70-year-old man, without previously known history of psorias is, was treated with terbinafine, 250 mg/day, for onychomycosis. Ten days l ater, a plantar pustular psoriasis appeared. The psoriasis cleared up after discontinuation of terbinafine and institution of antipsoriatic therapy. Discussion. Terbinafine is an antifungal agent widely use in the treatment of onychomycosis. A skin reaction occurs in 3 p. 100 of patients. Only 24 c ases of flare-up of previous psoriasis or psoriasis de novo after terbinafi ne have been described. The psoriasis generally clears after discontinuatio n of terbinafine. So, terbinafine is perhaps not the best first line therap y for onychomycosis in patients with psoriasis.