Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

Sarika M. Ramachandran, Jonathan S. Leventhal, Loren G. Franco, Adnan Mir, Ruth F. Walters, Andrew G. Franks

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Subacute cutaneous lupus erythematosus (SCLE) is a well-defined subtype of lupus erythematosus, characterised by photosensitivity, annular and/or psoriasiform lesions, variable systemic involvement and presence of circulating SSA/anti-Ro antibodies. SCLE may be idiopathic or drug-induced. Both the idiopathic and drug-induced forms of SCLE are analogous in their clinical, serological and histological features. Drug-induced SCLE has been reported with various oral agents, but to our knowledge this is the first reported case due to a topical medication. A 34-year-old female foot masseuse presented with a 2-month history of scaly, erythematous lesions isolated to the dorsal hands and interdigital spaces. She had used topical terbinafine, a topical antifungal cream, to her clients' feet for a number of years. ANA and anti-SSA/Ro antibodies were positive. Physical examination, serology and histopathology were consistent with SCLE. We propose that our patient's unique presentation of SCLE may be explained by a prolonged occupational exposure to topical terbinafine as a foot masseuse. While oral terbinafine is a drug known to cause drug-induced SCLE, to our knowledge, this is the first topically induced form of the disease.

Original languageEnglish (US)
Article numbere000207
JournalLupus Science and Medicine
Volume4
Issue number1
DOIs
StatePublished - Jan 2017

ASJC Scopus subject areas

  • Immunology

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    Ramachandran, S. M., Leventhal, J. S., Franco, L. G., Mir, A., Walters, R. F., & Franks, A. G. (2017). Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands. Lupus Science and Medicine, 4(1), [e000207]. https://doi.org/10.1136/lupus-2017-000207