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Int J Dermatol. 2017 Apr;56(4):405-414. doi: 10.1111/ijd.13434. Epub 2017 Jan 13.

Acute generalized exanthematous pustulosis: clinical characteristics, etiologic associations, treatments, and outcomes in a series of 28 patients at Mayo Clinic, 1996-2013.

Author information

1
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN, USA.
2
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
3
Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.

Abstract

BACKGROUND:

Acute generalized exanthematous pustulosis (AGEP) is a rare skin condition typically caused by medications. The objective of this study was to examine the clinical features, causes, and outcomes of AGEP at a sole tertiary care center.

METHODS:

A retrospective review of patients with AGEP (European Study of Severe Cutaneous Adverse Reactions score of ≥ 5) seen at Mayo Clinic (Rochester, MN, USA) between January 1, 1996, and December 31, 2013, was conducted.

RESULTS:

Of 28 patients (mean age at onset: 56 years), 17 (61%) were women. The development of AGEP was attributed to medications in 25 patients (89%), with clindamycin the most common culprit (six patients). Three patients (11%) had mucous membrane involvement, and 21 (75%) showed systemic involvement. Ten patients (36%) received systemic corticosteroids for treatment of AGEP. Skin findings resolved within 15 days in 26 patients (93%) (mean time to resolution: 7.6 days). 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.

CONCLUSIONS:

A previous history of drug reactions and clindamycin causation were more common in the present cohort than in prior reports. A small subset of patients experienced new-onset non-AGEP skin eruptions within a few months of the resolution of AGEP.

PMID:
28084022
DOI:
10.1111/ijd.13434
[Indexed for MEDLINE]

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