Acute Generalised Exanthematous Pustulosis with Subepidermal Blisters of the Distal Extremities Induced by Diltiazem

Gesierich, Anja; Rosé, Christian; Bröcker, Eva‐Bettina; Trautmann, Axel; Leverkus, Martin

doi:10.1159/000092840

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Following medical examination and positive patch testing of metamizole that has been reported to be a reliable test method [9], metamizole seems to be the most likely drug causative for this severe immune reaction, although it is not among the most frequent causative drugs responsible for an AGEP [10]. However, besides the most common causative drugs like antibiotics [11] or diltiazem [12], a huge variety of drugs including even corticosteroids [13] have been reported to induce AGEP.…”

Section: Discussionmentioning

confidence: 99%

Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Eyerich¹,

Traidl‐Hoffmann²,

Albert³

et al. 2008

Dermatology

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A 69-year-old woman with a history of acute generalized exanthematic pustulosis (AGEP) caused by metamizole is described. Furthermore, she had suffered from an untreated psoriasis since the age of 20. After an adequate therapy of both psoriasis and AGEP, yellow-brownish, static, coalescing, lucent nodules on the thighs and upper arms became apparent. Histology of skin biopsies revealed a prominent band of mature adipocytes in the dermis. We diagnosed a lipomatous metaplasia of the dermis and hypothesize that this metaplasia occurred as a consequence of the severe and chronic inflammation of the skin.

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Section: Discussionmentioning

confidence: 99%

Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Eyerich¹,

Traidl‐Hoffmann²,

Albert³

et al. 2008

Dermatology

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“…Localized AGEP has been reported over a mid‐sternal scar and on the face, cheeks and lips . Diltiazem has also been reported to induce AGEP limited to the distal limbs with sparing of the trunk and flexural folds . AGEP‐like contact dermatitis has also been described in a woman in her 28th week of pregnancy who developed pruritic, erythematous lesions that demonstrated subcorneal pustules consistent with AGEP on histopathology.…”

Section: Introductionmentioning

confidence: 99%

Acute generalized exanthematous pustulosis: atypical presentations and outcomes

Kostopoulos

Krishna

Brinster

et al. 2014

Acad Dermatol Venereol

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Acute generalized exanthematous pustulosis (AGEP) is an acute drug eruption characterized by erythematous plaques and papules studded with numerous, pinpoint pustules. Several atypical clinical presentations and triggers of AGEP have been described in the literature. These include systemic presentations similar to toxic epidermal necrolysis (TEN) and drug-induced hypersensitivity syndrome (DIHS) and localized presentations mimicking other medication reactions. We herein aim to review atypical presentations and medication triggers of AGEP to assist clinicians in recognizing this condition and making appropriate therapeutic interventions.

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“…[ 42 43 ] Diltiazem has been reported to induce AGEP limited to the distal limbs with sparing of the trunk and flexural folds. [ 44 ] AGEP-like allergic contact dermatitis to hydrocortisone butyrate propionate has also been described. [ 45 ] AGEP-like contact dermatitis to methylchloroisothiazolinone has been described, in the third-trimester pregnant female, which was consistent with AGEP on histopathology.…”

Section: Clinical Featuresmentioning

confidence: 99%

Acute generalised exanthematous pustulosis: An update

Das

Sarda³

et al. 2018

Indian J Dermatol

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Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction and is attributed to drugs in more than 90% of cases. It is a rare disease, with an estimated incidence of 1–5 patients per million per year. The clinical manifestations characterised by the rapid development of sterile pustular lesions, fever and leucocytosis. Number of drugs has been reported to be associated with AGEP, most common being the antibiotics. Histopathologically there is intraepidermal pustules and papillary dermal oedema with neutrophilic and eosinophilic infiltrations. Systemic involvement can be present in more severe cases. Early diagnosis with withdrawal of the causative drug is the most important step in the management. Treatment includes supportive care, prevention of antibiotics and use of a potent topical steroid.

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Acute Generalised Exanthematous Pustulosis with Subepidermal Blisters of the Distal Extremities Induced by Diltiazem

Cited by 10 publications

References 11 publications

Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Acute generalized exanthematous pustulosis: atypical presentations and outcomes

Acute generalised exanthematous pustulosis: An update

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