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Ramachandran SM, Leventhal JS, Franco LG, et al. Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands. Lupus Sci Med. 2017;4(1):e000207doi: 10.1136/lupus-2017-000207.
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 & medicine, 4(1), e000207. https://doi.org/10.1136/lupus-2017-000207
Ramachandran, Sarika M, et al. "Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands." Lupus science & medicine vol. 4,1 (2017): e000207. doi: https://doi.org/10.1136/lupus-2017-000207
Ramachandran SM, Leventhal JS, Franco LG, Mir A, Walters RF, Franks AG. Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands. Lupus Sci Med. 2017 Mar 13;4(1):e000207. doi: 10.1136/lupus-2017-000207. eCollection 2017. PMID: 28331627; PMCID: PMC5353283.
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Lupus Sci Med. 2017 Mar 13;4(1):e000207. doi: 10.1136/lupus-2017-000207. eCollection 2017.

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

Lupus science & medicine

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

Affiliations

  1. The Ronald O. Perelman Department of Dermatology , New York University School of Medicine , New York, New York , USA.
  2. The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA; Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, New York, USA.

PMID: 28331627 PMCID: PMC5353283 DOI: 10.1136/lupus-2017-000207

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.

Keywords: Autoantibodies; Autoimmune Diseases; Systemic Lupus Erythematosus

Conflict of interest statement

Competing interests: None declared.

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