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]
Entire Body System
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Fever
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]
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Lymphedema of the Lower Extremity
A 67-year-old woman with cellulitis of the left lower extremity was admitted with marked bilateral lymphedema of the lower extremities and diffuse erythema of the left lower extremity from foot to knee. She was given clindamycin and then vancomycin. [ncbi.nlm.nih.gov]
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Plethora
Sampson, Olga Klinkova, Julie Vitko and Beata Casanas, A Plethora of Pustules: Acute Generalized Exanthematous Pustulosis, The American Journal of Medicine, (2018). [doi.org]
Respiratoric
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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]
Gastrointestinal
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Colic
We describe a case of a woman with AGEP, who presented with generalized pustulosis lesions after the use of piroxicam for renal colic. [ncbi.nlm.nih.gov]
Jaw & Teeth
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Periodontitis
We assume that the administration of the 5 different antibiotics resulted in type IV allergy as well as secondary infection with Enterococcus faecium and Staphylococcus aureus, while the underlying periodontitis also contributed to the severity of this [ncbi.nlm.nih.gov]
Eyes
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Prolapse
We report a 50-year-old man who developed fever and a sudden eruption of widespread pustules 12 days after ingestion of celecoxib prescribed for a prolapsed intervertebral disc. [ncbi.nlm.nih.gov]
Skin
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Erythema
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]
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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]
Stevens Johnson and TEN are characteristically different from AGEP by their slower onset (and longer duration) of 1-3 weeks, blisters instead of pustules, mucosal involvement, and lack of leukocytosis [4]. [oatext.com]
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]
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Skin Rash
She had a history of TB and experienced rifampin-induced skin rash. She was treated for TB with moxifloxacin, isoniazid, ethambutol, and pyrazinamide. [ncbi.nlm.nih.gov]
He was started on topical steroids for the skin rash, which was suspected to be acute generalized exanthematous pustulosis. [jintensivecare.biomedcentral.com]
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]
Cutaneous adverse reactions (CAR) attributed to fenofibrate are rare and include acute hypersensitivity reactions such as severe skin rashes, urticaria, photosensitivity reactions, contact dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis [edoj.org.eg]
Available from: Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and more rarely by viral infections, the intake of toxic substances or insect bites. [1] It is clinically characterized [ijp-online.com]
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Pruritus
Furthermore, the patient suffered from severe pruritus in the affected areas. [karger.com]
The patient complained of a burning sensation of the skin in addition to pruritus; and simultaneously had a fever of 38-39 C as the eruption expanded. Discussion: A spider bite may represent a possible causative factor of AGEP. [jstage.jst.go.jp]
Cutaneous adverse reactions (CAR) attributed to fenofibrate are rare and include acute hypersensitivity reactions such as severe skin rashes, urticaria, photosensitivity reactions, contact dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pruritus [edoj.org.eg]
Off‐target ADRs may or may not be associated with immunological memory, although they can manifest with a variety of shared clinical features, including maculopapular exanthema, severe cutaneous adverse reactions (SCARs), angioedema, pruritus and bronchospasm [doi.org]
CASE REPORT A 69-year-old male was referred to our clinic because of generalized pruritus and erythema accompanied by high fever. He had a history of hypertension for 20 years and had been taking 16 mg candesartan cilexetil tablets. [kjim.org]
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Erythema of the Chest
A 38-year-old primigravida whose labor had been induced developed erythema over her chest and abdomen. She was transferred to our department after a failed vacuum extraction, and delivered a mature infant by forceps. [ncbi.nlm.nih.gov]
Neurologic
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Headache
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]
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]
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]
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Neglect
While many of the most severe cutaneous reactions are likely to present initially to the emergency department, it is important not to neglect the role of the ambulatory care provider in managing those cases which present to a clinic. [ijcasereportsandimages.com]
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
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Liver Enzymes Abnormal
A 58-year-old woman with type 1 diabetes was hospitalized for treatment of an extensive blistering rash on the buttocks and trunk accompanied by fever, hypotension, tachycardia, neutrophilia, impaired renal function, and liver enzyme abnormalities. [ncbi.nlm.nih.gov]
Treatment
With immediate discontinuation of terbinafine and various treatment protocols, both patients demonstrated recovery followed by skin desquamation during the subsequent weeks. [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
The prognosis is generally good and the disease self limited, after withdrawal of the triggering drug. In this report the authors describe a case of AGEP, triggered by ceftriaxone in a patient with psoriasis vulgaris. [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]
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]
The drug etiology was excluded and spider bite was implicated as the etiological agent in these cases of AGEP which are the first such reported cases in India. [e-ijd.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]
Generalized pustular psoriasis: A clinical and epidemiological study of 104 cases. Br J Dermatol. 1968; 80: 771- 793. PMID: 4236712 3. U.S. Food and Drug Administration. [email protected]: Fenofibrate. Available at: . Accessed August 10, 2008. 4. [edoj.org.eg]
Pathophysiology
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]
In this review, we highlight the main clinical, pathophysiological and diagnostic aspects of this peculiar form of drug allergy. [jle.com]
At present, Alzheimer disease has no effective treatment due to its complex pathophysiology, which is not yet completely understood. [semanticscholar.org]
However, the pathophysiology and natural course are unknown. [ijdvl.com]
The pathophysiology for the development of these drug-independent cases of AGEP is unclear. Viral infections have also been observed to be associated with the development of SJS, SJS/TEN, and TEN in the absence of a causative drug. [en.wikipedia.org]
Prevention
Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids. [ncbi.nlm.nih.gov]
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]
Definitive treatment of AGEP depends on removal of the offending agent, supportive care, and prevention of infection. The offending agent is a drug in 90% of cases [2]. More than 54 reported drugs have been implicated. [ijcasereportsandimages.com]