scholarly journals Rapid Involution of Pustules during Topical Steroid Treatment of Acute Generalized Exanthematous Pustulosis

2017 ◽  
Vol 9 (1) ◽  
pp. 135-139 ◽  
Author(s):  
Christiane Kley ◽  
Carla Murer ◽  
Julia-Tatjana Maul ◽  
Barbara Meier ◽  
Florian Anzengruber ◽  
...  
Keyword(s):  
Topical Steroid ◽  
Steroid Treatment ◽  
Clobetasol Propionate ◽  
Topical Steroids ◽  
First Line ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Cutaneous Adverse Reaction ◽  
Amoxicillin Clavulanic Acid ◽  
Diffuse Erythema ◽  
Exanthematous Pustulosis

Acute generalized exanthematous pustulosis (AGEP) is a dramatic generalized pustular rash of severe onset, which is considered a serious cutaneous adverse reaction to drugs. However, even though the clinical features are impressive and are often accompanied by systemic inflammation, it can be controlled quickly and safely by topical steroids subsequent to interruption of the offending drug. Here, we describe the management of a case and the evolution of the pustular rash. An elderly woman consulted with a generalized crop of 2–3 mm, nonfollicular pustules on erythematous background. In the 4 preceding weeks, she had been using amoxicillin/clavulanic acid for a bacterial implant infection and rivaroxaban. The clinical EuroSCAR criteria including the histology confirmed AGEP. Her medication was stopped and topical clobetasol propionate was used. Within 24 h, the development of new pustules ceased and the patient was discharged after 7 days of hospitalization with only a faint, diffuse erythema and focal desquamation remaining. This and many other cases in the literature suggest that topical steroids should be considered as a first-line treatment option, especially as systemic steroids themselves can sometimes induce generalized pustulosis.

scholarly journals TANTANGAN FARMAKOLOGI PENGGUNAAN STEROID TOPIKAL PADA PASIEN ORAL LICHEN PLANUS

2019 ◽  
Vol 6 (1) ◽  
pp. 30
Author(s):  
Revi Nelonda ◽  
Nanan Nur’aeny ◽  
Irna Sufiawati
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Clinical Signs ◽  
Topical Steroid ◽  
Topical Steroids ◽  
First Line ◽  
Spicy Food ◽  
Diffuse Erythema ◽  
Chronic Autoimmune Disease ◽  
Oral Lichen

Background: Oral lichen planus (OLP) is a chronic autoimmune disease sprinkled by T cells on the oral mucosal surface. The goal of OLP treatment is to eliminate erythema, ulceration and relieve symptoms. Corticosteroids are the first line in the treatment of OLP, either systemically or topically. The problem arises when using topical steroids, namely the time of topical steroid attachment to the oral mucosa, especially in cases of OLP with clinical desquamative gingivitis. Some studies suggest that the use of individual gingival tray can overcome this problem. Objective: To provide information on topical steroid use in OLP cases with desquamative gingivitis clinical signs.Case Management: Women, age 31, complain that pain with burning on the lips and mouth is aggravated by spicy food. Intraoral examination shows irregular white plaques on the buccal, labial and dorsal mucosa of the tongue accompanied by diffuse erythema in the anterior gingiva of the upper and lower jaws. Patients diagnosed with OLP. Lesions improve 3 months after topical steroid administration, except lesions on the gingiva. Gingival individual tray is then used to obtain adequate attachment of topical steroids on the gingiva surface. The gingiva showed significant improvement after a month later.Conclusion: The use of topical steroid concoctions applied to the gingival individual tray is effective in treating OLP lesions especially with clinical signs of desquamative gingivitis.

scholarly journals Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1004
Author(s):  
Morgan Sussman ◽  
Anthony Napodano ◽  
Simo Huang ◽  
Abhirup Are ◽  
Sylvia Hsu ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Clinical Course ◽  
Pustular Psoriasis ◽  
Topical Steroids ◽  
Inflammatory Disorder ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Cutaneous Adverse Reaction ◽  
History Of ◽  
Exanthematous Pustulosis ◽  
Crucial Part

The similarity between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP) poses problems in the diagnosis and treatment of these two conditions. Significant clinical and histopathologic overlap exists between PP and AGEP. PP is an inflammatory disorder that has numerous clinical subtypes, but all with sterile pustules composed of neutrophils. AGEP is a severe cutaneous adverse reaction that is also characterized by non-follicular sterile pustules. Clinical features that suggest a diagnosis of PP over AGEP include a history of psoriasis and the presence of scaling plaques. Histologically, eosinophilic spongiosis, vacuolar interface dermatitis, and dermal eosinophilia favor a diagnosis of AGEP over PP. Importantly, PP and AGEP vary in clinical course and treatment. PP treatment involves topical steroids, oral retinoids, and systemic immunosuppressants. Newer therapies targeting IL-36, IL-23, IL-1, and PDE-4 have been investigated. The removal of the offending agent is a crucial part of the treatment of AGEP.

Acute Generalized Exanthematous Pustulosis With Multiple Organ Dysfunction Syndrome

2013 ◽  
Vol 22 (3) ◽  
pp. 270-273 ◽  
Author(s):  
Ghulam Rehman Mohyuddin ◽  
Manar Al Asad ◽  
Lindsay Scratchko ◽  
Ghulam Khaleeq
Keyword(s):  
Lower Extremity ◽  
Rare Condition ◽  
Skin Condition ◽  
Multiple Organ ◽  
Drug Induced ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Left Lower Extremity ◽  
Causative Drug ◽  
Diffuse Erythema ◽  
Exanthematous Pustulosis

Acute generalized exanthematous pustulosis is a rare condition characterized by sterile pustules on erythematous and edematous tissue. Mostly drug induced, this condition can also be caused by other factors. Cases due to vancomycin are rare. 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. 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. After successful treatment of other complications, the skin condition improved. Because vancomycin is frequently used, clinicians should be aware of the possibility of acute generalized exanthematous pustulosis. Because the pustulosis decreases after withdrawal of the causative drug, being able to diagnose and differentiate the abnormality from other conditions is prudent.

scholarly journals First presentation of Sneddon-Wilkinson disease with unexpected immunoglobulin A gammopathy: A case report and review of the literature

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982643
Author(s):  
Julia N Mayba ◽  
C Nicole Hawkins
Keyword(s):  
Clinical Presentation ◽  
Hematologic Malignancy ◽  
Topical Therapy ◽  
Immunoglobulin A ◽  
Lymphoproliferative Disorders ◽  
Review Of The Literature ◽  
First Line ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Exanthematous Pustulosis ◽  
First Line Treatment

We present a case of Sneddon-Wilkinson disease in a 52-year-old female at her first presentation to dermatology. Outlined in the case are various investigations undertaken at this initial presentation, including rheumatologic and hematologic malignancy markers, which identified immunoglobulin A gammopathy. The systemic and topical therapies used to treat the patient’s condition are described, as well as her response to these treatments. In this discussion, we explain the epidemiology, pathophysiology, and clinical presentation of Sneddon-Wilkinson disease. Various medical conditions having known association with Sneddon-Wilkinson disease are discussed, including immunoglobulin A or immunoglobulin G monoclonal gammopathies and lymphoproliferative disorders. A comprehensive differential diagnosis for Sneddon-Wilkinson disease is provided, including immunoglobulin A pemphigus, acute generalized exanthematous pustulosis and pustular psoriasis, among others. We describe the systemic and topical therapy options for the treatment of Sneddon-Wilkinson disease, of which first line treatment is systemic dapsone. This patient serves as an excellent case of Sneddon-Wilkinson disease with unexpected immunoglobulin A gammopathy.

Acute Generalized Exanthematous Pustulosis Induced by Amoxicillin/Clavulanic Acid

2015 ◽  
Vol 19 (6) ◽  
pp. 592-594 ◽  
Author(s):  
Ekaterini Syrigou ◽  
Dimitra Grapsa ◽  
Andriani Charpidou ◽  
Konstantinos Syrigos
Keyword(s):  
Clavulanic Acid ◽  
Patch Testing ◽  
Clinical Presentation ◽  
Drug Induced ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Amoxicillin Clavulanic Acid ◽  
Exanthematous Pustulosis ◽  
Histopathologic Features

Drug-induced acute generalized exanthematous pustulosis is a rare pustular skin reaction, most commonly triggered by antibiotics. Although its diagnosis is based primarily on the presence of specific clinical and histopathologic features, additional in vivo (patch testing) or in vitro testing may be required, especially in atypical cases, to more accurately determine the causative agent. The authors report a histologically confirmed case of acute generalized exanthematous pustulosis that was induced by amoxicillin/clavulanic acid, as documented by subsequent patch testing, and presented with generalized painful lymphadenopathy, mimicking an acute infectious process. This is a very rare and diagnostically challenging clinical presentation of acute generalized exanthematous pustulosis, which has been reported, to the best of our knowledge, only once previously.

A case of acute generalized exanthematous pustulosis caused by exposure to Atovaquone/proguanil

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
Marta Arsuaga ◽  
Rosa de Miguel ◽  
Elena Trigo ◽  
Pablo Barreiro ◽  
Fernando de la Calle ◽  
...  
Keyword(s):  
Adverse Events ◽  
Steroid Treatment ◽  
Allergy Testing ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Medical Evaluation ◽  
Severe Adverse Events ◽  
Exanthematous Pustulosis

We present a returning traveler with acute generalized exanthematous pustulosis after atovaquone/proguanil prophylaxis. Diagnosis was confirmed with biopsy and allergy testing, symptoms resolved after steroid treatment. Atovaquone/proguanil prophylaxis is generally well tolerated, however, some patients may present severe adverse events that require prompt medical evaluation and treatment.

Acute Generalized Exanthematous Pustulosis in a Patient after Stem Cell Transplantation

2010 ◽  
Vol 14 (4) ◽  
pp. 181-184
Author(s):  
Petra Cetkovská ◽  
Nina Benáková
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem ◽  
Pustular Eruption ◽  
Immune Alteration ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Cutaneous Adverse Reaction ◽  
History Of ◽  
Exanthematous Pustulosis

Background: A severe generalized pustular eruption occurred several months after allogeneic hematopoietic stem cell transplantation for multiple myeloma in a patient being treated with antibiotics for respiratory infection. Neither he nor his donor had a history of psoriasis. Methods: The patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone without improvement; later, acitretin and methylprednisolone were used successfully. The eruption slowly subsided, and therapy was discontinued. Four months later, the patient experienced a recurrent severe pustular eruption associated with fever and leukocytosis, and the same treatment was used successfully again. Results and Conclusion: The patient has not experienced relapses in the ensuing 3 years. Acute generalized exanthematous pustulosis is a rare cutaneous adverse reaction triggered most commonly by drugs with a tendency to resolve spontaneously. The surprisingly prolonged, refractory, and relapsing course of the eruption in our patient might be due to the immune alteration and the polypharmacologic therapy after stem cell transplantation. Antécédents: Une éruption pustulaire généralisée aiguë s'est produite chez un patient traité aux antibiotiques contre une infection respiratoire, plusieurs mois après une allogreffe de cellules souches hématopoïétiques pour myélome multiple. Ni le patient ni le donneur n'ont des antécédents de psoriasis.

A Case of Acute Generalized Exanthematous Pustulosis by Cefixime with Oral Mucosal Involvement

2020 ◽  
Vol 15 (3) ◽  
pp. 236-239 ◽  
Author(s):  
Ramanachary Namoju ◽  
Mohammed Ismail ◽  
Vinay Kumar Golla ◽  
Tejaswini Bamini ◽  
Thanmaya Lakshmi Akarapu ◽  
...  
Keyword(s):  
Case Report ◽  
Management Strategies ◽  
Beta Lactam ◽  
Mucosal Membrane ◽  
Acute Generalized Exanthematous Pustulosis ◽  
First Case ◽  
Cutaneous Adverse Reaction ◽  
Mucosal Involvement ◽  
Lactam Antibiotic ◽  
Exanthematous Pustulosis

Acute generalized exanthematous pustulosis (AGEP) is a rare severe cutaneous adverse reaction characterized by the development of numerous sterile and non-follicular pustules on an erythematous base with no or minimal mucous membrane involvement associated with fever and leucocytosis. Cefixime is a cephalosporin-type beta-lactam antibiotic commonly used for the management of several infections. The Cefixime-induced AGEP cases are known to be rare. Here, we present the case report of a 26-year old female who developed Cefixime-induced AGEP with mucosal membrane involvement. To the best of our knowledge, this is the first case to report the mucosal membrane involvement in Cefixime-induced AGEP. We are presenting this case report to draw the attention on the existence and plethora of symptoms of Cefixime-induced AGEP hoping that the clinicians will reckon these in their differential diagnosis and implement the appropriate management strategies for this rare adverse event in their clinical practice.

Sign in / Sign up

Export Citation Format

Share Document