Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series
Acute Generalized Exanthematous Pustulosis (AGEP) is a rare, severe adverse cutaneous drug reaction characterized by fever and numerous sterile, non-follicular pustules on an erythematous base that manifests 2 to 14 days after drug exposure. While systemic antibiotics, particularly beta-lactams...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
2025-03-01
|
| Series: | Nepal Journal of Dermatology, Venereology & Leprology |
| Subjects: | |
| Online Access: | https://nepjol.info/index.php/NJDVL/article/view/69062 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849226789777309696 |
|---|---|
| author | Irene Nirmala Thomas Sahana Begum Mohamed Sadiq Nithya Priyadharshini Shanmugam Arishta Bala Saranya Mohan |
| author_facet | Irene Nirmala Thomas Sahana Begum Mohamed Sadiq Nithya Priyadharshini Shanmugam Arishta Bala Saranya Mohan |
| author_sort | Irene Nirmala Thomas |
| collection | DOAJ |
| description |
Acute Generalized Exanthematous Pustulosis (AGEP) is a rare, severe adverse cutaneous drug reaction characterized by fever and numerous sterile, non-follicular pustules on an erythematous base that manifests 2 to 14 days after drug exposure. While systemic antibiotics, particularly beta-lactams and macrolides, are frequently implicated, they can also be triggered by other drugs, including hydroxychloroquine, antifungals, antivirals, antineoplastics, and herbal remedies like Ginkgo biloba, curcumin, etc. This case series reports three unusual instances of AGEP after intake of tablet paracetamol, native medicines, and syrup azithromycin. All three patients met the EUROSCAR diagnostic criteria for AGEP, with scores indicating a definite diagnosis. Treatment included the withdrawal of the offending drug, symptomatic management, topical and systemic steroids, resulting in the resolution of lesions within a week. This series emphasizes the necessity of considering rare and less common etiologies, highlighting that drugs like paracetamol, native medicines, and azithromycin, while infrequently associated, can still provoke AGEP. Comprehensive evaluation of all possible triggers is crucial for accurate diagnosis and effective treatment.
|
| format | Article |
| id | doaj-art-5de9a3b7b686417fb47b1aaa0b38af0b |
| institution | Kabale University |
| issn | 2091-0231 2091-167X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) |
| record_format | Article |
| series | Nepal Journal of Dermatology, Venereology & Leprology |
| spelling | doaj-art-5de9a3b7b686417fb47b1aaa0b38af0b2025-08-24T10:05:28ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2025-03-01231Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case SeriesIrene Nirmala Thomas0https://orcid.org/0000-0002-3508-3251Sahana Begum Mohamed Sadiq1https://orcid.org/0009-0006-2786-7626Nithya Priyadharshini Shanmugam2https://orcid.org/0000-0002-0565-8931Arishta Bala3https://orcid.org/0009-0009-0769-2461Saranya Mohan4https://orcid.org/0000-0002-8396-9356Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet, Tamil NaduShri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet, Tamil Nadu, IndiaShri Sathya Sai Medical College and Research Institute Ammapettai, Chengalpet, Tamil Nadu, IndiaShri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet, Tamil Nadu, IndiaShri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet, Tamil Nadu, India Acute Generalized Exanthematous Pustulosis (AGEP) is a rare, severe adverse cutaneous drug reaction characterized by fever and numerous sterile, non-follicular pustules on an erythematous base that manifests 2 to 14 days after drug exposure. While systemic antibiotics, particularly beta-lactams and macrolides, are frequently implicated, they can also be triggered by other drugs, including hydroxychloroquine, antifungals, antivirals, antineoplastics, and herbal remedies like Ginkgo biloba, curcumin, etc. This case series reports three unusual instances of AGEP after intake of tablet paracetamol, native medicines, and syrup azithromycin. All three patients met the EUROSCAR diagnostic criteria for AGEP, with scores indicating a definite diagnosis. Treatment included the withdrawal of the offending drug, symptomatic management, topical and systemic steroids, resulting in the resolution of lesions within a week. This series emphasizes the necessity of considering rare and less common etiologies, highlighting that drugs like paracetamol, native medicines, and azithromycin, while infrequently associated, can still provoke AGEP. Comprehensive evaluation of all possible triggers is crucial for accurate diagnosis and effective treatment. https://nepjol.info/index.php/NJDVL/article/view/69062AzithromycinNative medicinesParacetamol |
| spellingShingle | Irene Nirmala Thomas Sahana Begum Mohamed Sadiq Nithya Priyadharshini Shanmugam Arishta Bala Saranya Mohan Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series Nepal Journal of Dermatology, Venereology & Leprology Azithromycin Native medicines Paracetamol |
| title | Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series |
| title_full | Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series |
| title_fullStr | Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series |
| title_full_unstemmed | Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series |
| title_short | Unveiling Uncommon Etiologies of Acute Generalized Exanthematous Pustulosis - A Case Series |
| title_sort | unveiling uncommon etiologies of acute generalized exanthematous pustulosis a case series |
| topic | Azithromycin Native medicines Paracetamol |
| url | https://nepjol.info/index.php/NJDVL/article/view/69062 |
| work_keys_str_mv | AT irenenirmalathomas unveilinguncommonetiologiesofacutegeneralizedexanthematouspustulosisacaseseries AT sahanabegummohamedsadiq unveilinguncommonetiologiesofacutegeneralizedexanthematouspustulosisacaseseries AT nithyapriyadharshinishanmugam unveilinguncommonetiologiesofacutegeneralizedexanthematouspustulosisacaseseries AT arishtabala unveilinguncommonetiologiesofacutegeneralizedexanthematouspustulosisacaseseries AT saranyamohan unveilinguncommonetiologiesofacutegeneralizedexanthematouspustulosisacaseseries |