Lin Jeng-Hsien, Sheu Hamm-Ming, Lee J Yu-Yun
Department of Dermatology, National Cheng Kung University Hospital, 138, Sheng-Li Road, Tainan, Taiwan.
Eur J Dermatol. 2002 Sep-Oct;12(5):475-8.
Acute generalized exanthematous pustulosis (AGEP) resembles generalized pustular psoriasis, but may manifest targetoid lesions, purpura, and blisters in addition to pustules. We describe a case of AGEP with erythema multiforme (EM)-like features in a 35-year-old woman who presented with acute onset of high fever and a strikingly polymorphic eruption consisting of numerous tiny pustules on erythematous bases, marked facial edema, oral and genital erosions, targetoid vesicular and purpuric lesions, pustules in string-of-pearl configuration and ring-like vesicles. The histology revealed, in addition to subcorneal pustules, vacuolar interface dermatitis with involvement of eccrine glands, and microabscesses in pilosebaceous structures. Systemic corticorsteroid and antibiotics were initiated, resulting in rapid resolution without recurrence. Recognition of EM-like lesions on a background of generalized pustular eruption could facilitate the diagnosis of AGEP and the institution of appropriate treatment.
急性泛发性脓疱性皮病（AGEP）类似于泛发性脓疱型银屑病，但除脓疱外，还可能出现靶形损害、紫癜和水疱。我们描述了一例35岁女性的AGEP病例，其具有多形红斑（EM）样特征，该患者急性起病，高热，皮疹显著多形性，表现为红斑基础上的众多微小脓疱、明显的面部水肿、口腔和生殖器糜烂、靶形水疱和紫癜性损害、珍珠串状脓疱和环状水疱。组织学检查显示，除角质层下脓疱外，还有累及小汗腺的空泡界面性皮炎以及毛囊皮脂腺结构中的微脓肿。给予全身性皮质类固醇和抗生素治疗后，病情迅速缓解且未复发。认识到在泛发性脓疱性皮疹背景下出现的EM样损害有助于AGEP的诊断及采取恰当的治疗措施。
