Cases: Sep 08
32 year old woman develops a fever and a sudden eruption of numerous small non-follicular pustules on an erythematous base covering the face. History of acne rosacea treated with macrolides on a daily basis for many years.
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What is the diagnosis and which differential diagnosis should be considered?
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This is a rare skin rash, usually secondary to a drug reaction. The disease is characterized by several features:
- Intraepidermal or subcorneal pustules associated with dermal oedema with focal necrosis of the keratinocytes
- Fever (38°C)
- Blood neutrophil count >7000/mm³
The most frequent causes of AGEP seem to be drug reactions and acute infections with enteroviruses. Amongst drugs there is a great predominance (80%) of antibiotics as causative agents. Acute evolution with spontaneous resolution of pustules in less than 15 days.
Pustular psoriasis must be considered amongst differential diagnoses.
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Answer
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Acute generalized exanthematous pustulosis (AGEP) |
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