Acute generalized exanthematous pustulosis: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Erythema Multiforme]] | *[[Erythema Multiforme]] | ||
*[[Drug rash]] | *[[Drug rash]] | ||
Revision as of 02:26, 27 November 2019
Background
- T-cell mediated rash with systemic features
- >90% of cases attributable to a medication (usually an antibiotic)
- Mortality rate of ~5%
Clinical Features
- Onset 1-5 days after starting causative medication
- Rash:
- Large areas of edematous erythema with numerous small, non-follicular pustules
- Predominantly affects main body folds and upper trunk, but can involve face
- NO mucous membrane involvement (in contrast to SJS/TEN)
- Systemic findings:
- Fever
- Leukocytosis, specifically neutrophilia
- +/- Facial swelling
- +/- Hepatitis
- +/- Eosinophilia
Differential Diagnosis
Erythematous rash
- Positive Nikolsky’s sign
- Febrile
- Staphylococcal scalded skin syndrome (children)
- Toxic epidermal necrolysis/SJS (adults)
- Afebrile
- Febrile
- Negative Nikolsky’s sign
- Febrile
- Afebrile
Evaluation
- Clinical diagnosis
- CBC
- BMP
- LFTs
Management
- Stop inciting agent
- IVF- treat similar to fluid resuscitation in burns
- Wound care, infection control
Disposition
- Admit