JLE

European Journal of Dermatology

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Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts Volume 20, numéro 4, July-August 2010

Auteurs
Department of Internal Medicine, Ghent University Hospital, De Pintelaan 185 9000 Gent, Belgium, Department of Dermatology, Ghent University Hospital, De Pintelaan 185 9000 Gent, Belgium

Acute generalized exanthematous pustulosis (AGEP) is a significant adverse cutaneous reaction, most often provoked by drugs and acute infections. The recognition of AGEP is important, in order to avoid confusion with a systemic infection and consequently to avoid incorrect treatment. The clinical hallmark is the presence of multiple disseminated sterile pustules on an erythematous background, associated with fever and a massive neutrophilia and sometimes eosinophilia. The disease is characterised by an acute onset and a spontaneous resolution within 2 weeks. The involvement of drug-specific T cells in the pathomechanism can be confirmed by positive skin patch tests and lymphocyte transformation tests. In this review, we highlight the main clinical, pathophysiological and diagnostic aspects of this peculiar form of drug allergy.