Rare Skin Eruption Caused by Paracetamol: A Case of Acute Generalized Exanthematous Pustulosis
Journal of Case Reports in Medical Science, Volume 9, Issue 1,
Page 40-45
DOI:
10.56557/jocrims/2023/v9i18270
Abstract
Background: This case report aims to enhance clinicians' ability to identify and effectively manage rare skin eruptions, specifically focusing on Acute Generalized Exanthematous Pustulosis (AGEP) by providing valuable insights into the context of its diagnostic challenges and clinical implications.
Presentation of Case: We present a case of AGEP in a 16-year-old Indian boy who developed generalized pustulosis after taking Paracetamol (Acetaminophen). The patient's diagnosis was initially delayed due to the resemblance of AGEP with other skin conditions. Furthermore, the inadvertent reintroduction of Paracetamol exacerbated the condition.
Discussion: We discuss various treatment options and emphasize the importance of prompt and accurate diagnosis of AGEP by utilizing the AGEP validation. By employing this scoring system, clinicians can enhance their diagnostic accuracy and avoid unnecessary delays in treatment initiation.
Conclusion: The prompt identification of AGEP using the AGEP validation score is crucial for timely management. This case report highlights the potential risks associated with common drugs like Paracetamol and emphasizes the need for vigilance in prescribing medications. Clinicians should be aware of the distinctive features of AGEP and consider it as a differential diagnosis in patients presenting with pustular skin eruptions following drug intake. Improved awareness and application of diagnostic tools can aid in better patient outcomes.
- Acute generalized exanthematous pustulosis
- AGEP validation score
- skin eruption
- drug reaction
- severe cutaneous adverse reactions
- paracetamol
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References
Sidoroff A. Acute generalized exanthematous pustulosis. Chem Immunol Allergy. 2012;97:139-48. DOI:10.1159/000335625
Fernando SL. Acute generalised exanthematous pustulosis. Australas J Dermatol. 2012;53:87-92. DOI:10.1111/j.1440-0960.2011.00845.x
Szatkowski J, Schwartz RA. Acute generalised exanthematous pustulosis (AGEP): A review and update. J Am Acad Dermatol. 2015;73:843-848. DOI:10.1016/j.jaad.2015.07.017
de Coninck AL, van Strubarq AS, Pipeleers-Marichal M, et al. Acute Generalized Exanthematous Pustulosis Induced by Paracetamol. Dermatology. 1996;193:338-341. DOI:10.1159/000246286
Mashiah J, Brenner S. A Systemic Reaction to Patch Testing for the Evaluation of Acute Generalized Exanthematous Pustulosis. Arch Dermatol. 2003;139:1181-1183. DOI:10.1001/archderm.139.9.1181
Ohtsuka T, Yamakage S, Yamazaki S. Acute generalized exanthematous pustulosis: an apoptotic process as suggested by immunohistochemical analysis. Dermatology. 1998;197:188-189.
Haro-Gabaldón V, Sánchez-Sánchez-Vizcaino J, Ruiz-Avila P, et al. Acute generalized exanthematous pustulosis with cytomegalovirus infection. Int J Dermatol. 1996 Oct;35(10):735-7. DOI: 10.1111/j.1365-4362.1996.tb00653.x.
Feldmeyer L, Heidemeyer K, Yawalkar N. Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy. Int J Mol Sci. 2016;27:1214. DOI:10.3390/ijms17081214
Britschgi M, Steiner UC, Schmid S, et al. T-cell involvement in drug-induced acute generalized exanthematous pustulosis. J Clin Invest. 2001;107(11):1433-41. DOI:10.1172/JCI12118
Lee EY, Koh MJA. Acute generalized exanthematous pustulosis in children and adolescents in Singapore: A ten-year retrospective review. Pediatr Dermatol. 2021;38(2):424-430. DOI: 10.1111/pde.14482.
Sidoroff A, Halevy S, Bavinck JN, Vaillant L, Roujeau JC. Acute generalized exanthematous pustulosis (AGEP) - a clinical reaction pattern. J Cutan Pathol. 2001;28:113-119. DOI: 10.1034/j.1600-0560.2001.028003113.x.
Spencer JM, Silvers DN, Grossman ME. Pustular eruption after drug exposure: is it pustular psoriasis or a pustular drug eruption? Br J Dermatol. 1994;130(4): 514-9. DOI:10.1111/j.1365-2133.1994.tb03389.x
Yanes D, Nguyen E, Imadojemu S, Kroshinsky D. Cyclosporine for treatment of acute generalized exanthematous pustulosis: A retrospective analysis. J Am Acad Dermatol. 2020;83(1):263-265. DOI: 10.1016/j.jaad.2020.02.069.
Zhang L, Xu Q, Lin T, Ruan S, Lin M, Bao C, et al. Case Report: Successful Treatment of Acute Generalized Exanthematous Pustulosis With Secukinumab. Front Med (Lausanne). 2021;8:758354. DOI: 10.3389/fmed.2021.758354.
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