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Acute generalized exanthematous pustulosis in Adult
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Acute generalized exanthematous pustulosis in Adult

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Contributors: Susan Burgin MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Acute generalized exanthematous pustulosis (AGEP) is a relatively rare reaction pattern consisting of an acute febrile pustular eruption following medications, mercury exposure, or viral infection (enterovirus, adenovirus, cytomegalovirus [CMV], Epstein-Barr virus [EBV], hepatitis B). The syndrome occurs within 2 weeks of starting the medication and may occur as soon as 48 hours after initial drug ingestion. AGEP has been reported in infants, children, and adults. Fever, typically 39°C (102.2°F), is a near constant feature and persists about 1 week.

The causative drugs are primarily antibiotics, typically penicillins, and macrolides, but many other drug culprits have been reported, including norfloxacin, diltiazem, nitrazepam, cephradine, doxycycline, vancomycin, isoniazid, carbamazepine, nifedipine, acetaminophen, quinidine, itraconazole, piperazine, ibuprofen, and pyrimethamine.

Codes

ICD10CM:
L27.0 – Generalized skin eruption due to drugs and medicaments taken internally

SNOMEDCT:
238996003 – Drug-induced toxic pustuloderma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 02/24/2017
Last Updated: 04/04/2017
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Acute generalized exanthematous pustulosis in Adult
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Acute generalized exanthematous pustulosis : Fever, Pustule, Widespread, WBC elevated, Reaction 2 days to 2 weeks after drug
Clinical image of Acute generalized exanthematous pustulosis
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