Acute Generalized Exanthematous Pustulosis Caused by Diltiazem

Abstract

Acute generalized exanthematous pustulosis is clinically characterized by fever, pruritus and an acute pustular eruption. It can be described as having an abrupt onset and then spontaneous resolution occurs shortly after the start of symptoms, and there is usually only a single episode. Most cases have been triggered by the ingestion of drugs. Diltiazem hydrochloride is a calcium channel blocker that is commonly used for treating hypertension and angina. This drug was found to be the responsible agent in our current patient. There have been 9 such case reports in the English medical literature, yet this is the first such report in the Korean medical literature. We present the case of a 51-year-old male who experienced an acute generalized exanthematous pustulosis due to diltiazem hydrochloride and we review the relevant literature. (Ann Dermatol 23(1) 108∼110, 2011)

Hydrochlorothizide-induced acute generalised exanthematous pustulosis presenting with bilateral periorbital impetigo

“…With increasing frequency of combination medication prescription, this phenomenon may erroneously lead to a minor increase in the number of reported drug allergies. Although HCTZ and losartan, alone or in combination, are commonly prescribed as antihypertensives, their roles in AGEP are not well documented in the primary literature or established pharmacology texts 7…”

“…The most common causes include anti-infective agents (aminopenicillins, quinolones, antibacterial sulfonamides and terbinafine), antimalarials and diltiazem. To the best of our knowledge, to date there has only been one report of hydrochlorothiazide (HCTZ)-induced AGEP 7. There has never been a case report of losartan-induced AGEP.…”

Acute generalized exanthematous pustulosis with two case reports

“…Az AGEP akutan jelentkezô, lázzal, kiterjedt oedemával, erythaemával kezdôdô megbetegedés, melyet nagyszámú, döntôen a hajlatokra és a végtagok hajlító felszínére lokalizálódó, nem follikuláris eloszlású, steril, <5mm átmérôjû pustula megjelenése követ. Ritkán erythaema multiforme-szerû target léziók, vesiculák, hólyagok és purpurák is elôfordulhatnak (2,3). Kezdete típusosan igen gyors, általában 1-3 nappal a gyógyszer bevezetése után jelentkezik.…”