Trust Me, This Is the Worst “Acne” of Your Life!

Acute generalized exanthematous pustulosis in the ambulatory care setting

“…It is commonly associated with mild mucous membrane involvement (20%), mild eosinophilia (33.3%), lymphadenopathy, reduced creatinine clearance, and mildly elevated aminotransferases [2,7]. If the patient has significant eosinophilia, cytopenia, or organ impairment, SJS or DRESS may be more likely diagnoses than AGEP [9]. While organ involvement is uncommon, it may be more likely to occur if the patient is elderly or immunocompromised [11].…”

“…One review identified systemic involvement in the acute phase of the disease in approximately 17% of patients, including liver, kidney, bone-marrow, and lung involvement [11]. Mortality rates have been reported between 2-5% [9,11].…”

“…However, the differential diagnosis remains broad in the acute phase of AGEP, including: toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), subcorneal pustular dermatosis (Sneddon-Wilkinson disease), pustular vasculitis, sweet syndrome, and pustular psoriasis (von Zumbusch type) [8]. DeClerk [9] et al developed a table to help differentiate AGEP from many other similar rashes based on the timing interval from drug exposure, associated symptoms, and appearance of the eruption. Additionally, the EuroSCAR validation score for AGEP can be used to determine the likelihood that the eruption is consistent with AGEP based on the eruption's morphology, course, and histology [2].…”

EM:RAP Commentaries in the Annals of Emergency Medicine: Peer Review and Financial Disclosure Needed

“…1 We created this new format because Annals is always interested in serving its readers better. Although a key part of our mission is to provide high-quality research content, we know that our subscribers would also like more clinically relevant material.…”

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“…1 We created this new format because Annals is always interested in serving its readers better. 1 We created this new format because Annals is always interested in serving its readers better.…”