-Case Reports-

Contact Dermatitis Caused by Efinaconazole and Luliconazole

Kazuhisa Fujimoto, Hanao Yamaguchi, Yohei Otsuka, Nobuko Mayumi and Hidehisa Saeki

Department of Dermatology, Nippon Medical School, Tokyo, Japan

We report a case of contact dermatitis caused by both efinaconazole, a topical triazole antifungal drug, and luliconazole, a topical imidazole antifungal drug. Positive patch test reactions were observed with efinaconazole and luliconazole. A patch test with lanoconazole also elicited a positive reaction. We hypothesized that structural similarity between luliconazole and lanoconazole led to cross-reaction, and that the dithiolane ring common to both drugs or the structure of the vinyl imidazole with a dithiolane ring could be the antigenic determinant.
Since efinaconazole and luliconazole have no common structures, patients could be sensitized to both drugs separately. The antigenic determinant of efinaconazole is unknown. However, the chemical formula of ravuconazole, an oral triazole antifungal drug, is similar to that of efinaconazole. Clinicians should carefully consider potential cross-reactivity between these drugs.

J Nippon Med Sch 2021; 88: 253-257

Keywords
triazole, efinaconazole, luliconazole, contact dermatitis, cross-reaction

Correspondence to
Kazuhisa Fujimoto, MD, PhD, Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
funfun@nms.ac.jp

Received, May 25, 2020
Accepted, July 31, 2020