Acute generalized exanthematous pustulosis

Abstract

A broad spectrum of drugs is associated with AGEP, a T cell-mediated reaction. Genetic susceptibility and the possible role of other risk factors in AGEP should be further evaluated in larger studies of AGEP patients with a validated diagnosis.

Cutaneous symptoms in drug allergy: what have we learnt?

“…In this process an intradermal infiltration of activated CD4 and CD8 T cells producing granulocyte-macrophage colony-stimulating factors (GM-CSF), with IFN-g and TNF-a with the release of perforin/granzyme B and FasL, which are responsible for keratinocyte death [23,24]. These T lymphocytes also produce IL8 (CXCL-8), which is responsible for neutrophil chemoattraction and activation [7,23,[25][26][27].…”

“…Urticaria is characterized by wheals, sometimes accompanied by angioedema. AGEP consists of edematous erythema followed by small nonfollicular sterile pustules that may be accompanied by a nonerosive mucous membrane [3,6,7]. Fixed drug eruptions (FDEs) consist of solitary or just a few pruritic, erythematous macules that evolve into edematous plaques; they recur at the same sites with reexposure and lead to hyperpigmentation [3,8,9].…”

“…CD4 þ and CD8 þ cells expressing high levels of the activation marker and IFN-g have been detected in the supernatant of carbamazepine-stimulated T-cell clones [10]. In AGEP, drug-specific T cells have been obtained from patch test sites and blood [25,26,53], producing large amounts of IL8/CXCL8 [7], with a predominant Th1 cytokine profile (GM-CSF and IFN-g) and TNF-a [47]. Some T-cell clones like CXCL8þ display a Th2 pattern (IL4 and IL5) [47].…”

Acute generalized exanthematous pustulosis after ceftriaxone use resembling sepsis

“…Skin reaction may occur in less than 2-3 days [7]. Discontinuing the suspected drug and supportive therapy is the principal treatment [10]. Corticosteroids (oral, topical, systemic) may be given, but no significant difference has been reported between treatment regimens in the course and recovery period [11].…”

T cell–mediated acute localized exanthematous pustulosis caused by finasteride

“…[1][2][3] Skin symptoms arise quickly within a few hours and resolve rapidly within a few days without treatment. The rash is commonly accentuated in the large folds.…”