Photo Credit: SeventyFour
The following is a summary of “Comparison of Acute Generalized Exanthematous Pustulosis with Maculopapular Rash in a Swiss Patient Cohort: A Single-Center Retrospective Study,” published in the April 2025 issue of Dermatology by Fröhlich et al.
Acute generalized exanthematous pustulosis (AGEP) was recognized as a rare drug-induced skin reaction marked by sudden sterile pustules, fever, and neutrophilia, with well-defined clinical distinctions from maculopapular rash (MPR) but limited understanding of its mechanisms and triggers.
Researchers conducted a retrospective study to explore the pathomechanism, causative medications, and additional contributing factors of AGEP.
They compared clinical characteristics, suspected causative drugs, drug test outcomes, and comorbid conditions between 52 individuals with confirmed AGEP and 63 individuals with MPR, with both diagnoses confirmed clinically and histologically.
The results showed beta-lactam antibiotics were the most frequent causative drugs in both AGEP and MPR, while antimycotics (P = 0.002), glucocorticoids (P = 0.0106), and NSAIDs (P = 0.0064) appeared more often in AGEP. Skin patch tests and lymphocyte transformation tests (LTT) had higher positivity in MPR, with all non-beta-lactam antibiotics tested via LTT yielding negative results in AGEP. Comorbidity analysis indicated a potential link between upper gastrointestinal tract disorders and AGEP.
Investigators concluded that the identified differences in causative drugs and comorbidities between AGEP and MPR underscored the need for further research to improve the understanding and management of AGEP.
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