Acute generalized exanthematous pustulosis

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Background

  • T-cell mediated rash with systemic features
  • >90% of cases attributable to a medication (usually an antibiotic)
  • Mortality rate of ~5%

Clinical Features

Acute generalized exanthematous pustulosis.png
  • 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
  • Systemic findings:
    • Fever
    • Neutrophilia
    • +/- Facial swelling
    • +/- Hepatitis
    • +/- Eosinophilia


Differential Diagnosis

Evaluation

  • Clinical diagnosis
  • CBC
  • BMP
  • LFTs

Management

  • Stop inciting agent
  • IVF- treat similar to fluid resuscitation in burns
  • Wound care, infection control

Disposition

  • Admit

See Also

External Links

References