Systemic allergic dermatitis presenting as acute generalized exanthematous pustulosis due to betamethasone sodium phosphate

Gambini, D; Sena, Paolo; Raponi, Francesca; Bianchi, Leonardo; Hansel, Katharina; Tramontana, Marta; Stingeni, Luca

doi:10.1111/cod.13451

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…Although rarely, SAD has been described in subjects contact sensitized to CSs and subsequently treated with these drugs via the systemic route 1,6 . Clinical features of SAD by CSs include maculopapular, eczematous, urticaria‐like eruptions, and acute generalized exanthematous pustulosis 1,7 . The intra‐articular route has been reported rarely, and in these cases triamcinolone acetonide was exceptionally the culprit CS 1,8 .…”

Section: Discussionmentioning

confidence: 99%

“…1,6 Clinical features of SAD by CSs include maculopapular, eczematous, urticaria-like eruptions, and acute generalized exanthematous pustulosis. 1,7 The intra-articular route has been reported rarely, and in these cases triamcinolone acetonide was exceptionally the culprit CS. 1,8 To the best of our knowledge, this is the first report of SAD caused by intra-articular administration of triamcinolone acetonide presenting as SDRIFE and erythema multiforme-like eruption.…”

Section: Case Reportsmentioning

confidence: 99%

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Systemic allergic dermatitis from intra‐articular triamcinolone acetonide: Report of two cases with unusual clinical manifestations

et al. 2020

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heart failure, renal dysfunction, and hepatic disease. 4 After oral administration, it is rapidly absorbed and is known for its high bioavailability. It inhibits NaCl reabsorption in the medullary portion of the thick ascending limb of the loop of Henle. 5 In comparison with equipotent doses of furosemide, it produces a more prolonged water and electrolyte diuresis, but does not increase kaliuresis to the same extent. 6 Torasemide is used widely in cardiology. Phototoxic skin reactions this loop diuretic may be underreported. Management is simple by replacing this medication with another substance such as spironolactone, which does not belong to the sulfonylurea class.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportsmentioning

confidence: 99%

Systemic allergic dermatitis from intra‐articular triamcinolone acetonide: Report of two cases with unusual clinical manifestations

et al. 2020

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“…In the study cohort, seven deaths were recorded [75,91,104,132,151,182,221]. A summary description of the patients with a fatal outcome is included in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Drug Triggers and Clinic of Acute Generalized Exanthematous Pustulosis (AGEP): A Literature Case Series of 297 Patients

Vallejo-Yagüe

Torre

Mohamad

et al. 2022

JCM

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Acute generalized exanthematous pustulosis (AGEP) is a rare skin reaction, commonly caused by drugs. Available evidence mostly relies on small studies or case reports. We collected published AGEP case reports and, subsequently, described the patient characteristics, suspect and concomitant drugs, time to onset, disease management, and clinical prognosis. This study included 297 AGEP patients (64.3% women) obtained from 250 published case reports or case series with individual patient data. AGEP affected patients of all ages, but the majority of patients (88.2%) were ≥25 years old. The most frequently reported suspect drugs were anti-infectives for systemic use (36.5%), particularly antibacterials for systemic use (31.0%), and especially beta-lactam antibacterials (18.3%) and macrolides (4.3%). Other frequent suspect drugs were antineoplastics (12.2%), and anti-inflammatory/anti-rheumatic products (5.2%) plus hydroxychloroquine (12.8%). Mean time to onset was 9.1 days (standard deviation SD 13.94). Some patients developed fever (64.3%) and systemic involvement (18.9%), and most patients (76.4%) received pharmacological treatment for AGEP. Seven patients died, although five of them were already critically ill prior to AGEP. In conclusion, antibiotics remain the most common suspected cause of AGEP. While case mortality rate may be up to 2.5%, disentangling the role of AGEP on the fatal outcome from the role of the preexisting health conditions remains challenging.

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“…Severe ADR, like AGEP, have also been described. 112 Allergy to CS can be suspected also in cases of CS-sensitive diseases that do not respond or worse following the use of CS. [109][110][111] Budesonide and CS molecules without C16-methyl substitution or halogenation, such as hydrocortisone and methylprednisolone, are the stronger sensitizers.…”

Section: Heparinsmentioning

confidence: 99%

Skin tests in the diagnosis of adverse drug reactions

Stingeni

Bianchi

Tramontana

et al. 2020

G Ital Dermatol Venereol

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Systemic allergic dermatitis presenting as acute generalized exanthematous pustulosis due to betamethasone sodium phosphate

Cited by 8 publications

References 11 publications

Systemic allergic dermatitis from intra‐articular triamcinolone acetonide: Report of two cases with unusual clinical manifestations

Systemic allergic dermatitis from intra‐articular triamcinolone acetonide: Report of two cases with unusual clinical manifestations

Drug Triggers and Clinic of Acute Generalized Exanthematous Pustulosis (AGEP): A Literature Case Series of 297 Patients

Skin tests in the diagnosis of adverse drug reactions

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