Acute generalized exanthematous pustulosis
Management strategy
Treatment of AGEP involves establishing the correct diagnosis (Table 8.1) coupled with the withdrawal of any implicated medication (Table 8.2). Pustular psoriasis is its main differential diagnosis. A comprehensive drug history and a personal or family history of psoriasis is therefore required.
Table 8.1
(From Roujeau, et al., 1991. Arch Dermatol 127, 1333–1338.)
Table 8.2
Drugs and other substances reported to have caused AGEP
| Drugs |
| Antibiotics |
|
Penicillins: amoxicillin, ampicillin, bacampicillin, pipemidic acid, piperacillin, propicillin, tazobactam Macrolides: azithromycin, erythromycin Quinolones: ciprofloxacin, norfloxacin, ofloxacin Tetracyclines: doxycycline, minocycline Cephalosporins: cefaclor, cefazolin, cefuroxime, cephalexin, cephradine Aminoglycosides: gentamicin, isepamicin sulfate, streptomycin Other antibiotics: chloramphenicol, clindamycin, co-trimoxazole, imipenem/cilastatin, lincomycin, metronidazole, nifuroxazide, sulfamethoxazole, teicoplanin, vancomycin, daptomycin, telavancin |
| NSAIDs |
| Celecoxib, etoricoxib, ibuprofen, naproxen, nimesulide, valdecoxib |
| ACE inhibitors |
| Captopril, enalapril |
| Calcium channel blockers |
| Nifedipine, nimodipine |
| Anticonvulsants |
| Carbamazepine, phenobarbital, phenytoin |
| Analgesia (opioid/non-opioid) |
| Acetaminophen, paracetamol, morphine, codeine, dextropropoxyphene |
| Anti-platelets |
| Aspirin, ticlopidine, clopidogrel |
| Benzodiazepines |
| Clobazam, nitrazepam, tetrazepam |
| Antimalarials |
| Chloroquine, hydroxychloroquine, proguanil, pyrimethamine |
| Antipsychotics |
| Clozapine, chlorpromazine |
