Acute generalized exanthematous pustulosis associated with spider bite

Abstract

Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications.

Exanthema following a spider bite mimicking baboon syndrome

“…Some cases of acute generalized exanthematous pustulosis (AGEP) have been reported to be induced by spider bites, including three cases in Tunisia . The venom of the spider contains sphingomyelinase, which stimulates the liberation of cytokines, including great amounts of interleukin‐8 and granulocyte‐macrophage colony‐stimulating factor, which would trigger AGEP . Except for systemic signs, AGEP and SDRIFE have similar latency times, potential immunological pathogeneses, and causative drugs .…”

“…3 The venom of the spider contains sphingomyelinase, which stimulates the liberation of cytokines, including great amounts of interleukin-8 and granulocyte-macrophage colony-stimulating factor, which would trigger AGEP. 4 Except for systemic signs, AGEP and SDRIFE have similar latency times, potential immunological pathogeneses, and causative drugs. 1 As BS is a closely related entity, clinically and physiopathologically, to AGEP, it seemed logical to incriminate the spider bite in our case.…”

Acute generalised exanthematous pustulosis: an unusual cause of carpal tunnel syndrome

“…Although the patient’s inflammatory markers were negative, histology from the skin biopsy favoured AGEP. This is likely to have been triggered by the insect bite 8 9. The main differential diagnosis consists of pustular psoriasis, which can have a similar clinical presentation.…”

Acute Localized Exanthematous Pustulosis Induced by a Spider Bite

“…3 Several cases of AGEP following a spider bite have been reported in the literature. 4,5 Acute localized exanthematous pustulosis (ALEP) is a rare localized variant of AGEP. 2 To our knowledge, this is the first report of an ALEP induced by a spider bite and localized on an unusual topography.…”

“… 3 Several cases of AGEP following a spider bite have been reported in the literature. 4 , 5 Acute localized exanthematous pustulosis (ALEP) is a rare localized variant of AGEP. 2 …”