Acute Generalized Exanthematous Pustulosis in Children

Ersoy, Sibel; Paller, Amy S.; Mancini, Anthony J.

doi:10.1001/archderm.140.9.1172

Cited by 42 publications

(42 citation statements)

References 5 publications

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“…Tables 1 (most frequently mentioned drugs), 2A, 2B and 2C (less frequently mentioned drugs) give an overview of the broad range of drugs, with a predominance of antibacterials and a number of nonantibacterial drugs which may function as triggers. Although symptoms of AGEP can present at any age, it is uncommon in children and may be atypical in its presentation [13]. Viral infections (Coxsackie B4 virus, EpsteinBarr virus) and vaccinations [14] are suggested as the most frequent triggers in the pediatric population [13].…”

Section: General Characteristicsmentioning

confidence: 99%

“…Although symptoms of AGEP can present at any age, it is uncommon in children and may be atypical in its presentation [13]. Viral infections (Coxsackie B4 virus, EpsteinBarr virus) and vaccinations [14] are suggested as the most frequent triggers in the pediatric population [13]. Systemic medications (amoxicillin, vancomycin, ribavirin, labetolol) [15] and mercury exposure [16] have also been described as possible etiologies.…”

Section: General Characteristicsmentioning

confidence: 99%

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Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts

Speeckaert¹,

Speeckaert²,

Lambert³

et al. 2010

European Journal of Dermatology

106

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Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts Acute generalized exanthematous pustulosis (AGEP) is a significant adverse cutaneous reaction, most often provoked by drugs and acute infections. The recognition of AGEP is important, in order to avoid confusion with a systemic infection and consequently to avoid incorrect treatment. The clinical hallmark is the presence of multiple disseminated sterile pustules on an erythematous background, associated with fever and a massive neutrophilia and sometimes eosinophilia. The disease is characterised by an acute onset and a spontaneous resolution within 2 weeks. The involvement of drug-specific T cells in the pathomechanism can be confirmed by positive skin patch tests and lymphocyte transformation tests. In this review, we highlight the main clinical, pathophysiological and diagnostic aspects of this peculiar form of drug allergy.

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Section: General Characteristicsmentioning

confidence: 99%

Section: General Characteristicsmentioning

confidence: 99%

Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts

Speeckaert¹,

Speeckaert²,

Lambert³

et al. 2010

European Journal of Dermatology

106

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“…59 When drugs are involved, penicillin, cefixime, clindamycin, vancomycin, macrolides are the most common agents. 60 It presents with an acute onset of asymptomatic or mildly pruritic erythema, with hundreds of non-sterile follicular pustules, less than 5 mm in diameter, frequently accompanied by fever and fatigue. In very rare cases children can have overlapping findings of other severe reactions, such as DRESS (facial oedema) or SJS/TEN (some epidermal detachment).…”

Section: Introductionmentioning

confidence: 99%

Severe delayed skin reactions related to drugs in the paediatric age group: A review of the subject by way of three cases (Stevens–Johnson syndrome, toxic epidermal necrolysis and DRESS)

Belver

Michavila

Bobolea

et al. 2016

Allergologia et Immunopathologia

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Severe delayed drug-induced skin reactions in children are not common but potentially serious. This article describes aspects concerning the etiology, pathogenesis and clinical manifestations of these processes; it presents three paediatric cases, namely STS (Steven Johnson Syndrome), TEN (toxic epidermal necrolysis), probably related to amoxicillin/clavulanate and ibuprofen and DRESS (a drug reaction with eosinophilia and systemic symptoms) secondary to phenytoin; and in relation to them, the diagnosis and the treatment of these processes are discussed and reviewed. The AGEP (acute generalised exanthematous pustulosis) is also reviewed. The aetiological diagnosis of severe non-immediate reactions is difficult, and the value of current allergological testing is not well defined in these cases. Diagnosis is based on clinical history, the empirical risk of drugs to trigger SJS/TEN or DRESS, and the in vivo and in vitro testing of the suspect drug. Skin biopsy confirms that the clinical diagnosis and delayed hypersensitivity tests, especially the patch test and the lymphoblastic transformation test (LTT), may be important to confirm the aetiological diagnosis, in our cases emphasising the latter. These diseases can be life threatening (especially DRESS and TEN) and/or have a high rate of major complications or sequelae (SJS/TEN). The three cases described progressed well without sequelae. All were treated with corticosteroids, which is the most currently accepted treatment although the effect has not been clearly demonstrated.

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“…AGEP has rarely been described in the paediatric population (1,2). Viral illnesses, vaccinations (e.g.…”

mentioning

confidence: 99%

“…Viral illnesses, vaccinations (e.g. anti-pneumococcal vaccine) and drugs (up to 90% of cases) have been implicated in the pathogenesis of AGEP (1,2). Among drugs, the more commonly identified culprit agents are antibiotics (beta-lactatns, macrolides, quinolones, pristinamycin, anti-infective sulphonamides), antimycotics (terbinafine, ketoconazole), calcium channel blockers (diltiazem), analgesics, antipyretics (paracetamol) and antimalarials (1).…”

mentioning

confidence: 99%

Acute Generalized Exanthematous Pustulosis Induced by Paroxetine in an Adolescent Girl

Mameli¹,

Tadini²,

Cattaneo³

et al. 2013

Acta Derm Venerol

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Acute Generalized Exanthematous Pustulosis in Children

Cited by 42 publications

References 5 publications

Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts

Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts

Severe delayed skin reactions related to drugs in the paediatric age group: A review of the subject by way of three cases (Stevens–Johnson syndrome, toxic epidermal necrolysis and DRESS)

Acute Generalized Exanthematous Pustulosis Induced by Paroxetine in an Adolescent Girl

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