Mebazaa Amel, Kort Rim, Zaiem Ahmed, Elleuch Dalenda, Moula Hela, Cheikhrouhou Rim, Trojjet Sondes, Mokni Mourad, Ben Osman Amel, Daghfous Riadh
Service de Dermatologie, Hôpital LA RABTA, Tunis, Tunisia.
Tunis Med. 2010 Dec;88(12):910-5.
Acute generalized exanthematous pustulosis (AGEP) is an uncommon but severe dermatosis, characterized by acute occurrence of fever, and erythemato-oedematous rash, covered by sterile nonfollicular pustules. Most cases of AGEP have been described in association with the intake of drugs.
To determine clinical and prognostic features of AGEP in our patients.
All cases of AGEP diagnosed between 1992 and 2007 according to EuroSCAR criteria have been collected.
Twenty two patients (16 female, 6 male) with a mean age of 40.9 years (19-81) were included in the study. Clinical features showed in all cases an acute eruption with oedematous erythema, rapidly covered by nonfollicular pustules. The rash was mainly localized on big folds, trunk and/or limbs in 14 cases and generalized in 8 cases. A biological cytolysis was noted in 5 cases and a functional acute renal failure was objected in 2 cases. Etiological work up has found an association with the intake of drugs in 14 cases, a toxic cause (mercury) in 1 case and a B19 parvovirus infection in one case. The mean delay between drug intake and beginning of the eruption was 5 days (24 hours- 15 days). Pharmacovigilance enquiry has concluded to a probable or plausible causality in all our cases. Clinical features improved with drug or toxic withdrawal with a mean delay of 7 days (4 -12 days). A relapse of AGEP was observed in 2 cases after accidental introduction of the drug.
AGEP is a cutaneous side effect not to ignore, because of its severe prognosis in case of systemic involvement and the possibility of relapses in case of retake of the causal drug.
急性泛发性脓疱性皮病（AGEP）是一种罕见但严重的皮肤病，其特征为急性发热、红斑水肿性皮疹，并覆盖有无菌性非毛囊性脓疱。大多数AGEP病例都与药物摄入有关。
确定我们患者中AGEP的临床和预后特征。
收集了1992年至2007年间根据欧洲严重药物不良反应协作组（EuroSCAR）标准诊断的所有AGEP病例。
本研究纳入了22例患者（16例女性，6例男性），平均年龄为40.9岁（19 - 81岁）。所有病例的临床特征均表现为急性皮疹伴水肿性红斑，迅速被非毛囊性脓疱覆盖。皮疹主要局限于大褶皱处、躯干和/或四肢的有14例，全身性的有8例。5例出现生物性细胞溶解，2例出现功能性急性肾衰竭。病因学检查发现14例与药物摄入有关，1例与有毒物质（汞）有关，1例与B19细小病毒感染有关。药物摄入与皮疹开始出现之间的平均间隔时间为5天（24小时 - 15天）。药物警戒调查得出结论认为在我们所有病例中均存在可能或合理的因果关系。停用药物或有毒物质后临床特征改善，平均延迟时间为7天（4 - 12天）。2例患者在意外再次使用该药物后出现了AGEP复发。
AGEP是一种不可忽视的皮肤不良反应，因为其在出现全身受累时预后严重，且在再次使用致病药物时可能复发。
