Abstract
Acute generalised exanthematous pustulosis is a rare drug-induced dermatosis with an incidence of 1-5 cases per million cases per year, characterised by the appearance of hundreds of sterile pustules over erythematous and oedematous skin. Fever and neutrophilia are usually present. It has a rapid course and usually resolves following discontinuation of the precipitating drug or as a result of topical corticosteroid treatment. A patient with AGEP, who presented with generalized pustulosis lesions after the use of Flucloxacillin for cellulitis is described, along with the management and differential diagnosis of this condition.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Robert S Pennisi. Med J Of Australia August 2006: 184(11):583- AGEP. Case report
- Belda Junior ,W. & Ferrolla, A.C.J. Rev. Inst.Med.trop. S Paulo, 47(3): 171-176, 2005.
- Beylot, C.; Bioulac, P. & Doutre, M.S . Acute generalised exanthematous pustulosis. Four cases, Ann. Derm. Venereol, 107: 37: 48, 1980
- Beylot, C.: Doutre, M.S & Beylot- Baryy, M - Acute generalised exanthematous pustulosis. Semin.cut.Med.Surg, 15 : 244- 249, 1996
- Haro- Gabaldon, V.: Sanchez- Vizcaino ,J: Ruiz- Avila , P.et al.-Acute generalised exanthematous pustulosis with cytomegalovirus. Int J. Derm., 35: 735:737, 1996
- Adina M Dobrotoiu, Gabriela Turcu, D. G Fosea. Therapeutics, Pharmacology and Clinical Toxicology, Vol XIV, Number 4, Dec 2010, Pages 306-308.
- Khalid A. Hawasawi, Hawazin D Jan, Ali A Al Raddadi, Aymen H Alharbi, Mazin M Al Jabri, Mohamed B Satti, Acute generalised exanthematous pustulosis in a patient with plaque psoriasis.
- Lerch M, Bircher AJ, Sistemically induced allergic exanthema from mercury. Contact Dermatitis. 2004: 50: 349-353. Pub- Med
- Haro-Gabaldón V, Sánchez-Sánchez-Vizcaino J, Ruiz-Avila P, Gutiérrez-Fernández J, Linares J, Naranjo-Sintes R. Acute generalized exanthematous pustulosis with cytomegalovirus infection. Int J Dermatol. 1996; 35: 735–737. [PubMed]
- Anastasios Avgerinos, MD, Elpida Giannikaki, MD , Sabine Krasagakis, MD, PhD, and Ioannis E. Koutroubakis, MD, PhD. Acute generalised exanthematous pustulosis induced by Azathioprine in a patient with ulcerative colitis. The American Journal of Gastroenterology 2011. 1005-1007
- Momin SB, Del Rosso JQ, Michaels B, Mobini N. Acute generalized exanthematous pustulosis: An enigmatic drug-induced reaction. Cutis. 2009;83:291–8.PubMed
- Ronald J Sulewski Jr MD1, Marianna Blyumin MD2, Francisco A Kerdel MBBS2 Acute generalized exanthematous pustulosis due to clindamycin Dermatology Online Journal 14(7): 14
- Smith K, Norwood C, Skelton H. Do the physical and histologic features and time course in acute generalized exanthematous pustulosis reflect a pattern of cytokine dysregulation? J Cutan Med Surg 2003; 7: 7. PubMed
- Schmid S, Kuechler PC, Britschgi M. Acute generalized exanthematous pustulosis: Role of cytotoxic T cells in pustule formation. Am J Pathol 2002; 161: 2079. PubMe
- Mathew M. Avram, M.D., J.D., and Mai Hoang, M.D. Case 20-2009. A 79- year -Old Woman with blistering cutaneous Eruption. N Engl J Med 2009; 360: 2771-2777 June 25, 2009DOI:10.1056/NEJMcpc0900639
- Roujeau JC, Bioulac- Sage P, Bourseau C,Guillaume JC, Bernard P, Lok C, et al Acute generelaised exanthematous pustulosis. Analysis of 63 cases. Arch Dermoatol 1991: 127:1333-8
- Sidoroff A, Halevy S, Bavick JN, Vaillant L, Roujeau JC. Acute generalised exanthematous pustulosis- a clinical reaction pattern. J Cutan Pathol 2001: 28:113-9.
- Bajaj V, Simpson N. Oral corticosteroids did not prevent AGEP due to terbinafine. Acta Derm Venereol 2006: 86: 448-9.
- Annie O Morrison, MD; Chief Editor: Dirk M Elston, MD. Pustular Psoriasis Overview of Pustular Psoriasis.
- M. Carol McNeely, M.D., Ph.D; Joseph L. Jorizzo, M.D.; Alvin R. Solomon Jr., M.D.; Frank C. Schmalstieg, M.D., Ph.D.; Tito Cavallo, M.D.; Primary idiopathic cutaneous pustular vasculitis, JAAD, May 1986, Volume 14, Issue 5, Part 2, Pages 939–944.
- Auer-Grumbach P, Pfaffenthaler E, Soyer HP. Pustulosis acute generalisata is a post-streptococcal disease and is distinct from acute generalized exanthematous pustulosis. Br J Dermatol 1995; 133: 9.
- Braun-Falco O, Luderschmidt C, Maciejewski W, Scherer R. Generalized acute pustulosis. An unusual presentation of leukocytoclastic vasculitis. Hautarzt 1978; 29: 371.
