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March 2016

Paradoxical Reaction During a Course of Terbinafine Treatment of Trichophyton interdigitale Infection in a Child

Author Affiliations
  • 1Department of Dermatology, Allergology, and Venereology, Wrocław Medical University, Wrocław, Poland
  • 2Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2016;152(3):342-343. doi:10.1001/jamadermatol.2015.4293

We describe for the first time, to our knowledge, a paradoxical reaction to terbinafine treatment in the context of dermatophyte infection due to Trichophyton interdigitale.

A child weighing 30 kg and without any comorbidities and allergies and not taking any long-term medications was seen for erythematous, infiltrating, well-demarcated skin lesions located on the face, chest, abdomen, and limbs (Figure, A). Mycological culture yielded growth of Trichophyton mentagrophytes. The fungus was identified as T interdigitale by sequence analysis of the internal transcribed spacer and the D1/D2 domains of the large-subunit (26S) rRNA gene within the rDNA cluster using the polymerase chain reaction sequencing described elsewhere.1 The patient reported frequent contact with stray cats.

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