Presentation
These include systemic presentations similar to toxic epidermal necrolysis (TEN) and drug-induced hypersensitivity syndrome (DIHS) and localized presentations mimicking other medication reactions. [ncbi.nlm.nih.gov]
Clinical presentation includes acute onset of fever and pustulosis with leucocytosis, typically 48 h after ingesting the causative medication. Severe cases can present with mucous membrane and systemic organ involvement. [casereports.bmj.com]
Abstract: Objective: There are various adverse drug reaction (ADR) associated with pharmacological therapy that differ in clinical presentation, prognosis and therapy. [jyoungpharm.org]
Entire Body System
- Fever
Email: [email protected] m A 12-year-old boy presented with fever and generalized rash, starting 48 hours after administration of amoxicillin tablet for lower respiratory tract infection. [indianpediatrics.net]
She reported that two days previously she had developed fever and vomiting four hours after taking her first dose of fenofibrate (145 mg). [ncbi.nlm.nih.gov]
- Fishing
Catt CJ, Hamilton GM, Fish J, Mireskandari K, Ali A (2016) Ocular manifestations of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. [doi.org]
- Dentist
The response could be due to ingredients in the fluoride rinse used by the dentist or due to a transient bacteremia induced by tooth cleaning and micro abrasions in the mouth. [oatext.com]
Respiratoric
- Sore Throat
The patient presented with an erythematous and pustular eruption after taking 1 tablet of paracetamol for a sore throat. [thedoctorsdoctor.com]
throat was treated with three doses of acetaminophen (10 mg/kg), and 12 hours later, she developed an erythematous rash over her gluteal region and legs. [fda.gov]
- Pharyngitis
Anticonvulsant hypersensitivity syndrome has no relationship to dosage or serum concentration of anticonvulsants. [15] The reaction usually starts with low- or high-grade fever, and over the next 1 to 2 days a cutaneous reaction, lymphadenopathy and pharyngitis [ijdvl.com]
Skin
- Eruptions
A case report of a 48-year-old male who developed pustular eruptions after taking acetylsalicylic acid is reported here. [idoj.in]
Indeed, the predominance of the eruption in the folds, the rapid resolution of the eruption, the presence of eosinophils in the inflammatory infiltrate and the absence of histological features of conventional psoriasis suggest that our patient had an [symbiosisonlinepublishing.com]
AGEP is a rare drug eruption, usually to antibiotics. We report the first case in Canada of AGEP as an adverse reaction to HCQ. Clinicians should keep in mind the possibility of this severe skin eruption. [ncbi.nlm.nih.gov]
A history of preceding drug exposure and the rapid disappearance of eruption after the drugs is stopped, usually suggests a drug-induced aetiology rather than pustular psoriasis. [moh-it.pure.elsevier.com]
- Erythema
On the 7th day of hospitalization, body temperature returned to normal, pustules began to desquamate, erythema and edema subsided, and targetoid lesions partially improved. Figure 1: Facial edema with erythema and pustules. [archivesofmedicine.com]
On day 5, her condition worsened, with erythema involving the entire back. Although treatment with clindamycin and vancomycin was discontinued, acute generalized exanthematous pustulosis developed. [ncbi.nlm.nih.gov]
Among these, cutaneous eruptions are the most common type of all ADRs.Theclinical presentation of cutaneous drug eruptions ranges from common transient and benign erythema to the most severe forms such as Steven-Johnson syndrome (SJS), Toxic epidermal [jyoungpharm.org]
- Dermatitis
Persa, Stefan Haese and Nicolas Hunzelmann, Acute generalized exanthematous pustulosis caused by ibuprofen—Diagnosis confirmed by patch testing, Contact Dermatitis, 79, 1, (40-41), (2018). [doi.org]
Disulfiram hypersensitivity and rubber contact dermatitis. JAMA 1979;241:2061. [ PUBMED ] 8. Menné T. Flare-up of cobalt dermatitis from antabuse treatment. Contact Dermatitis 1985;12:53. 9. Zawar V, Nerlikar S. [ijdd.in]
0 Votes - Sign in to vote or reply. re: Acute generalized exanthematous pustulosis (AGEP) The code is 693.0 - dermatitis due to drug and medicine taken internally. AGEP is a reaction to a drug. [codapedia.com]
Contact Dermatitis. 1983;9(3):235–7. CrossRef PubMed Google Scholar Correia O, Nunes JP, Vaz-da-Silva MJ, Pires S, Brandao F, Mesquita-Guimarães J. Acute exanthematous pustular dermatitis after pneumococcal vaccine [Letter]. [link.springer.com]
In three patients (11%), generalized skin eruptions or dermatitis developed weeks to months after the resolution of AGEP. Twenty-four patients (86%) had a personal history of drug reactions before the development of AGEP. [ncbi.nlm.nih.gov]
- Skin Lesion
List of cutaneous conditions Skin lesion Pustulosis [en.wikipedia.org]
Prognosis is generally good and the skin lesions usually resolve in a few days with characteristic postpustular pin-point desquamation. We report three cases of AGEP induced by omeprazole, a drug with a good safety profile. [emmanuelfranca.com.br]
No acute reaction was observed; however, after 24 hours, due to the occurrence of typical dermonecrotic skin lesions associated with erythema and edema, Cefuroxime and Clindamycin were administered intramuscularly after medical advice was given. [jstage.jst.go.jp]
Skin lesions were accompanied by fever > 39ºC, leukocytosis (25/nl), neutrophilia (87%) and increased C-reactive protein level (CRP) (250 mg/l). [medicaljournals.se]
The pustular skin lesions and systemic findings resolved within 48 hours of hospitalization, and a second endoscopic examination was normal. Oral corticosteroid therapy was stopped on the fifth day. [kjim.org]
- Blister
We report a case of severe AGEP with extensive blistering mimicking toxic epidermal necrolysis (TEN) in a 47-year-old woman. This was associated with a life-threatening primary mumps infection, complicated by perimyocarditis and encephalitis. [ncbi.nlm.nih.gov]
It is characterised by the rapid appearance of areas of red skin studded with small sterile pustules (small blisters filled with white/yellow fluid). There tend to be more disease in skin folds. Facial swelling often arises. [dermnetnz.org]
The signs and symptoms of Acute Generalized Exanthematous Pustulosis may include the following: Skin rashes on the face, armpits, and groin Small blisters with white/yellow fluid Fever and malaise (feeling of illness) Facial swelling The onset of the [dovemed.com]
Neurologic
- Headache
He gave history of taking a tablet of ASA for headache, few hours before development of the rash and fever. He had taken the same drug earlier innumerable times in last 15 years, without any side effects; however, it was a 325 mg tablet this time. [idoj.in]
The 2 groups were compared in terms of age, gender, systemic symptoms (such as fever, myalgias, or headaches), duration of disease, history of drug allergy, laboratory data, and pathologic findings. [doi.org]
The skin eruptions are often pruritic and accompanied by fever, headache, a high number of neutrophils and eosinophils in the blood, and elevated blood levels of markers for inflammation (i.e. erythrocyte sedimentation rate and C reactive protein). [en.wikipedia.org]
After 24 hours, he was admitted with complaints of high fever (40℃), increased number of skin lesions, arthralgia, and headache. A dermatological examination revealed exanthema over 60% of the body accompanied by angioedema of the lips and eyelids. [kjim.org]
Workup
We were able to obtain a rapid workup and quick referral to dermatology. Also unique is our suspicion that the inciting agent was a topical lotion, however, no etiology was objectively confirmed. [ijcasereportsandimages.com]
Serum
- Neutrophilia
Its clinical hallmark is the sudden onset of multiple, disseminated, non-follicular, sterile pustules on an erythematous background usually arising in intertriginous folds, associated with fever, massive neutrophilia and sometimes eosinophilia. [ncbi.nlm.nih.gov]
Clinically AGEP is characterized by a large areas of eythema with sterile pustules, body temperature over 38ºC and neutrophilia (>5,000/mL). [archivesofmedicine.com]
About two days later, an eruption of non follicular pustular lesions developed accompanied with fever, leukocytosis and neutrophilia. The clinical and histological feature and the course of the disease suggested the diagnosis of AGEP. [moh-it.pure.elsevier.com]
Microbiology
- Human Parvovirus B19
Human parvovirus B19-induced vesiculopustular skin eruption Naides, S.J.; Piette, W.; Veach, L.A. Pustulose exanthématique aigüe généralisée révélatrice d’une primo-infection sévère à parvovirus B19 Derancourt, C.; Salmon-Ehr, V.; Perceau, G. [deepdyve.com]
Human parvovirus B19-induced vesiculopustular skin eruption. Am J Med 1988;84:968–972PMID : 2834947. 3. Roujeau JC. Clinical heterogeneity of drug hypersensitivity. Toxicology 2005;209:123–129PMID : 15767024. 4. [kjim.org]
AGEP has also been associated with viral infections, such as with Adenovirus, Coxsackie B4 virus, Cytomegalovirus, E. coli, Echovirus, Enterovirus, Epstein-Barr virus, Hepatitis B virus, and Human Parvovirus B19. [basicmedicalkey.com]
Acute generalized exanthematous pustulosis associated with a human parvovirus B19 infection. J Dermatol. 2007;34(2):121–3. CrossRef PubMed Google Scholar Paradisi A, Bugatti L, Sisto T, Filosa G, Amerio PL, Capizzi R. [link.springer.com]
Treatment
A 54-year-old female patient presented with severe AGEP due to hydroxychloroquine treatment prescribed for a primary Sjogren's syndrom. [archivesofmedicine.com]
Urine culture revealed Escherichia coli sensitive to multiple antibiotics and treatment was initiated with amoxicillin-clavulanate. [casereports.bmj.com]
Although treatment with clindamycin and vancomycin was discontinued, acute generalized exanthematous pustulosis developed. After successful treatment of other complications, the skin condition improved. [ncbi.nlm.nih.gov]
Hickson, Treatment of severe drug reactions by hemodialysis, International Journal of Dermatology, 57, 2, (177-182), (2017). Mindy M. [doi.org]
Prognosis
Abstract: Objective: There are various adverse drug reaction (ADR) associated with pharmacological therapy that differ in clinical presentation, prognosis and therapy. [jyoungpharm.org]
Although AGEP is a self-limiting disease with a favourable prognosis, secondary infections are a not infrequent complication in patients in poor general medical conditions. The reported mortality is about 5%. [ncbi.nlm.nih.gov]
Etiology
The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. [ncbi.nlm.nih.gov]
Corresponding Author: Rim Dhahri Internal medicine department, Principle Military Hospital Tunis, Tunisia Tel: 21671562305 Email: [email protected] Abstract Acute Generalized Exanthematous Pustulosis (AGEP) is a rare and severe cutaneous reaction whose etiology [archivesofmedicine.com]
Clinical Features: Acute-onset, generalized scarlitiniform eruption with sterile pustules, accompanied by fever Self-limited course of several days to a couple of weeks The etiology is a reaction to drugs, most commonly: Calcium channel blockers NSAIDs [dermpedia.org]
Nevertheless, data suggest that a viral etiology is responsible for no more than 25% of the cases. [scielo.br]
Epidemiology
The purpose of the present review is to update knowledge on acute generalized exanthematous pustulosis (AGEP) in terms of epidemiology, pathogenesis, cause, clinical features, diagnosis, and treatment. [ncbi.nlm.nih.gov]
Abstract Purpose of review The purpose of the present review is to update knowledge on acute generalized exanthematous pustulosis (AGEP) in terms of epidemiology, pathogenesis, cause, clinical features, diagnosis, and treatment. [doi.org]
A clinical and epidemiological study of 104 cases. Br J Dermatol 1968;80:771–793. Beylot C, Bioulac P, Doutre MS: Acute generalized exanthematic pustulosis (four cases). Ann Dermatol Venereol 1980;107:37–48. [karger.com]
A clinical and epidemiological study of 104 cases. Br J Dermatol 80: 771–793 PubMed CrossRef Google Scholar 5. Barbaud A, Reichert-Penetrat S, Trechot P, et al. (1998) The use of skin testing in the investigation of cutaneous adverse drug reactions. [link.springer.com]
Pathophysiology
In this review, we highlight the main clinical, pathophysiological and diagnostic aspects of this peculiar form of drug allergy. [jle.com]
The pathophysiological mechanism of AGEP remains unclear, although mutations in the IL36RN gene have been identified in a small subset of AGEP patients. [ncbi.nlm.nih.gov]
At present, Alzheimer disease has no effective treatment due to its complex pathophysiology, which is not yet completely understood. [semanticscholar.org]
A significant proportion of these reactions lack immunological memory and current data are informative for these ADRs with regard to disease pathophysiology, therapeutic targets and biomarkers which may identify patients at greatest risk. [doi.org]
Prevention
During the pustular phase, antiseptic solutions can help prevent infection. 2 Acknowledgments The authors thank Professor Luis Soares de Almeida for the histopathology pictures. [casereports.bmj.com]
Currently, there are no known measures to prevent Acute Generalized Exanthematous Pustulosis Avoiding medications similar to the one that caused the condition can help prevent its recurrence What is the Prognosis of Acute Generalized Exanthematous Pustulosis [dovemed.com]
Lastly, other pustular cutaneous reactions may present similarly and therefore accurate identification of this disease can prevent unnecessary diagnostic testing. [ncbi.nlm.nih.gov]
Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids. [doi.org]