Dermatology Unit, Singapore General Hospital, Singapore.
Int J Dermatol. 2010 May;49(5):507-12. doi: 10.1111/j.1365-4632.2010.04313.x.
ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS: We reviewed eight cases of acute generalized exanthematous pustulosis managed in a tertiary hospital in Singapore.
Acute generalized exanthematous pustulosis (AGEP) is a pustular reaction characterized by a sudden eruption of widespread nonfollicular sterile pustules associated with systemic symptoms. AGEP is primarily believed to be an adverse reaction to drugs. Outside of Europe, few reports exist on the clinical presentation of AGEP.
A retrospective review of patients who presented with AGEP to a Singapore tertiary hospital was performed.
Eight patients were diagnosed with AGEP in 2006-2007. All patients presented with a macular, maculopapular eruption prior to the onset of pustules. AGEP was characterized by nonfollicular, pinpoint pustules, which were generalized and accentuated in the flexural areas in seven of the patients. The remaining patient had erythematous patches, and scattered plaques studded with pustules. Other less common features included oral/genital mucositis, blisters and erosions. The mean duration from the cessation of medications to defervescence, resolution of pustules and normalization of leukocytosis was 5, 6, and 7 d, respectively. Despite the resolution of pustules, two patients had protracted clinical courses with evolution to generalized exfoliative dermatitis and Drug rash, eosinophilia, and systemic symptoms (DRESS), respectively. The implicated medications included antibiotics in six patients, morphine and phenytoin in one patient each.
Acute generalized exanthematous pustulosis is generally described as benign and self-limiting. However, in certain patients, the clinical course is prolonged and may exhibit features that overlap with other forms of cutaneous adverse drug reactions such as toxic epidermal necrolysis and DRESS.
急性泛发性发疹性脓疱病：我们回顾了在新加坡一家三级医院治疗的 8 例急性泛发性发疹性脓疱病患者。
急性泛发性发疹性脓疱病（AGEP）是一种脓疱性反应，其特征为突然出现广泛的非滤泡性无菌脓疱，并伴有全身症状。AGEP 主要被认为是药物的不良反应。在欧洲以外，关于 AGEP 的临床表现的报告很少。
对在新加坡一家三级医院就诊的 AGEP 患者进行回顾性分析。
2006-2007 年，8 例患者被诊断为 AGEP。所有患者均在出现脓疱前出现斑疹、斑丘疹性皮疹。AGEP 的特征是非滤泡性、针尖状脓疱，7 例患者的脓疱广泛分布并在屈侧区域加重。其余患者有红斑性斑块，伴有散在的脓疱。其他不常见的特征包括口腔/生殖器黏膜炎、水疱和糜烂。从停止用药到退热、脓疱消退和白细胞计数恢复正常的平均时间分别为 5、6 和 7 天。尽管脓疱消退，但 2 例患者的临床病程延长，分别发展为泛发性剥脱性皮炎和药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）。涉及的药物包括 6 例患者的抗生素、1 例患者的吗啡和苯妥英。
急性泛发性发疹性脓疱病通常被描述为良性和自限性。然而，在某些患者中，病程延长，并可能表现出与其他形式的药物性皮肤不良反应（如中毒性表皮坏死松解症和 DRESS）重叠的特征。
