Acute Generalized Exanthematous Pustulosis As A Cause of Exfoliative Dermatitis: A Case Report
Keywords:
Acute generalized exanthematous pustulosis (AGEP), exfoliative dermatitis (erythroderma), drug eruption, sterile pustules.Abstract
Introduction: Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse drug reaction characterized by an acute sterile pustular eruption and may present as erythroderma with extensive desquamation.
Case Presentation: A 59-year-old man presented with generalized erythema, pustules, fever, and extensive desquamation after exposure to multiple medications. Examination revealed diffuse erythematous plaques, scaling, erosions, and confluent pustules. Laboratory evaluation showed leukocytosis and elevated C-reactive protein. Histopathology demonstrated subcorneal pustules with neutrophilic and lymphocytic infiltrates, with negative microbiological investigations. A EuroSCAR score of 10 confirmed definite AGEP. The patient improved markedly within 9 days after withdrawal of suspected drugs, systemic corticosteroids, and supportive treatment, allowing discharge with good skin condition.
Discussion: AGEP is an important cause of acute erythroderma and may be triggered by medications such as amoxicillin and analgesics. Recurrence may occur following re-exposure.
Conclusion: AGEP should be considered in patients with acute erythroderma and pustules following recent drug exposure.
