Article
Emergency Medicine
Elie Saliba, Remie Chrabieh, Zeina Tannous
Summary: Acute generalized exanthematous pustulosis (AGEP) is a rare severe cutaneous adverse reaction typically caused by drugs, characterized by acute fever, edematous erythema with numerous sterile pustules. Fluconazole has been linked to several reported cases of AGEP, with our case being the fourth reported case attributed to fluconazole use.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Dermatology
Tian Wu, Yang He, Zhiqiang Fan, Wei Sun, Zuojun Li, Chunjiang Wang
Summary: This study aims to explore the clinical characteristics of terbinafine-induced acute generalized exanthematous pustulosis (AGEP) and provide reference for clinical diagnosis and treatment. The results showed that terbinafine-induced AGEP usually occurs within 2 weeks after administration and has a good prognosis after discontinuation.
DERMATOLOGIC THERAPY
(2023)
Article
Dermatology
Su Wang, Juan Bai, Jianjun Qiao
Summary: Acute generalized exanthematous pustulosis (AGEP) is a rare severe cutaneous adverse reaction that is believed to be a T cell-mediated hypersensitivity reaction, with medication being the most common cause. However, infections have also been reported to be associated with AGEP.
CLINICAL COSMETIC AND INVESTIGATIONAL DERMATOLOGY
(2023)
Article
Critical Care Medicine
Bernardo Correia, Joana Costa, Paula Egipto, Pedro Reis
Summary: Severe cutaneous adverse drug reactions are uncommon but potentially critical, requiring prompt diagnosis and treatment. Differential diagnosis based on clinical and histopathological features is crucial for appropriate management and prognosis of these conditions.
JOURNAL OF BURN CARE & RESEARCH
(2021)
Article
Medicine, General & Internal
Liangliang Zhang, Qiuyun Xu, Tingting Lin, Shifan Ruan, Mengting Lin, Chengbei Bao, Jing Zhang, Tao Liu, Ting Gong, Chao Ji
Summary: Acute generalized exanthematous pustulosis is a severe drug-related reaction typically treated with systemic corticosteroids. In this case, the patient showed improvement with secukinumab therapy.
FRONTIERS IN MEDICINE
(2021)
Letter
Dermatology
N. Mozafari, M. Farjami, E. Jamali, H. Rostami, Y. Ketabi
Summary: This case report presents a woman who developed a cutaneous drug reaction consistent with acute localized exanthematous pustulosis (ALEP) after using enoxaparin, highlighting enoxaparin as a novel causative agent for this type of drug reaction.
CLINICAL AND EXPERIMENTAL DERMATOLOGY
(2021)
Review
Dermatology
Rose Parisi, Hemali Shah, Alexander A. Navarini, Beda Muehleisen, Michael Ziv, Neil H. Shear, Roni P. Dodiuk-Gad
Summary: Acute Generalized Exanthematous Pustulosis (AGEP) is a rare, severe cutaneous adverse reaction that is mainly caused by drugs but can also be triggered by infections, vaccinations, ingestion of various substances, and spider bites. AGEP is characterized by edema, erythema, multiple sterile pustules, and subsequent peeling. The differential diagnoses for AGEP are broad and include infectious, inflammatory, and drug-induced etiologies. Treatment involves removing the offending drug or treating the underlying cause, if necessary, and providing supportive care. This review provides an overview and update on the epidemiology, pathogenesis, precipitating factors, differential diagnoses, diagnosis, and management of AGEP.
AMERICAN JOURNAL OF CLINICAL DERMATOLOGY
(2023)
Article
Medicine, General & Internal
Sadia Masood, Mohammad Rizwan, Saira Fatima, Palwasha Jalil
Summary: This case report presents a rare association of acute generalized exanthematous pustulosis (AGEP) with the biological agent cetuximab. The patient developed symptoms after cetuximab injection, which completely resolved after discontinuing the medication. This highlights the importance of being aware of this rare adverse effect of cetuximab and conducting proper examinations for diagnosis.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Dermatology
Mohammad Amin Hadavand, Benjamin Kaffenberger, Alexander M. Cartron, John C. L. Trinidad
Summary: Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction characterized by nonfollicular pustules on a red base that develop rapidly after drug exposure. It is caused by cytokines produced by drug-specific T cells that mediate neutrophilic pustule formation. Individuals with IL-36RN mutations may have an increased risk of developing AGEP. The condition typically presents with leukocytosis and fever during the acute pustular phase, followed by a self-limited recovery phase after stopping the offending drug. Severe cases may involve multiple organ systems.
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
(2022)
Review
Dermatology
Pia-Charlotte Stadler, Anna Oschmann, Katrin Kerl-French, Julia-Tatjana Maul, Eva Maria Oppel, Barbara Meier-Schiesser, Lars Einar French
Summary: Acute generalized exanthematous pustulosis (AGEP) is a potentially severe adverse cutaneous drug reaction that manifests as numerous sterile subcorneal pustules on erythematous skin. It can be associated with organ manifestations and typically resolves rapidly upon removal of the culprit drug and adequate steroid therapy. Recent experimental data suggest an early role of drug-induced innate immune activation and innate cytokines in the pathogenesis of AGEP.
Article
Medicine, General & Internal
Adrian Martinez-De la Torre, Eva van Weenen, Mathias Kraus, Stefan Weiler, Stefan Feuerriegel, Andrea M. Burden
Summary: The rare skin adverse drug reaction AGEP is poorly understood, with most studies focusing on single-drug outcomes. This study explored frequently reported drug combinations associated with AGEP, revealing a high frequency of cardiovascular drugs, particularly in combination with antibiotics. The network analysis identified 10 different communities, with the largest cluster primarily consisting of cardiovascular drugs.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Medicine, General & Internal
Morgan Sussman, Anthony Napodano, Simo Huang, Abhirup Are, Sylvia Hsu, Kiran Motaparthi
Summary: There are similarities between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP), but also clinical and histopathologic differences that guide the diagnosis and treatment for each condition. PP is an inflammatory disorder with various subtypes involving sterile pustules, while AGEP is a severe skin reaction characterized by non-follicular sterile pustules. Treatment options also differ for PP and AGEP.
MEDICINA-LITHUANIA
(2021)
Article
Medicine, General & Internal
Michael Makris, Antonios Kanelleas, Niki Papapostolou, Maria Pisimisi, Alexander C. Katoulis
Summary: Acute Localized Exanthematous Pustulosis (ALEP) is a rare skin reaction characterized by the sudden onset of multiple, small, sterile, non-follicular pustules in an erythematous and edematous base succeeding systemic drug administration. ALEP is considered a subtype of Acute Generalized Exanthematous Pustulosis (AGEP), although the exact pathogenic mechanism of the disease remains poorly defined. Numerous drugs have been implicated in the pathogenesis of ALEP, while contact mechanisms have also been reported. Identifying new agents-including minoxidil-which serve as inducers of drug-specific T-cell-mediated responses in the clinical spectrum of ALEP, adds further value in understanding the complex, yet unknown, pathophysiological mechanisms of this rare drug hypersensitivity reaction.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Dermatology
Rim Chaabouni, Emna Bahloul, Mariam Ennouri, Rim Atheymen, Khadija Sellami, Slaheddine Marrakchi, Slim Charfi, Sonia Boudaya, Meriem Amouri, Noura Bougacha, Hamida Turki
Summary: Our study aimed to characterize the clinical, laboratory, allergological, and genetic features of HCQ-induced AGEP. We found that the latent period and resolution duration for HCQ-induced AGEP may be longer due to metabolic characteristics of HCQ. Mutations in the IL36RN gene were not identified in our patients.
INTERNATIONAL JOURNAL OF DERMATOLOGY
(2021)
Review
Allergy
Anton C. de Groot
Summary: This article reviews the literature on positive patch-test results in acute generalized exanthematous pustulosis (AGEP). A total of 93 drugs were identified to have caused positive patch tests in 248 AGEP patients. The highest number of reactions was caused by beta-lactam antibiotics, other antibiotics, iodinated contrast media, and corticosteroids. Amoxicillin, pristinamycin, and diltiazem had the highest number of reactions. The sensitivity of patch testing in AGEP patients is largely unknown, but it may be similar to 50%.
CONTACT DERMATITIS
(2022)
