A Case of Drug Eruption Possibly Caused by a Generic Version of Terbinafine and Associated with Elevated Anti-HHV-6 Igg Antibody

Abstract

The patient was a 69-year-old man for whom Terbinal^® (generic terbinafine) was prescribed. Administration was discontinued after the appearance of systemic erythema caused suspicion of Terbinal^®-induced drug rash. The prolonged rash continued even after drug withdrawal, and he was referred to us. He presented with diffuse flushing of the face and systemic disseminated erythema. At first examination on admission, his anti-HHV-6 IgG antibody titer was 1:40; this rose to 1:160 by day 21 post-admission. The patient had not been exposed to any known causative agents of drug-induced hypersensitivity syndrome (DIHS); nevertheless, the clinical course and laboratory data resembled those of DIHS. There have been several recent reports of patients following a DIHS-like course after administration of drugs other than those known to cause this syndrome. Further accumulation of relevant case studies is required.