Sidoroff A
Univ.-Klinik für Dermatologie und Venerologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich,
Hautarzt. 2014 May;65(5):430-5. doi: 10.1007/s00105-013-2698-7.
Acute generalized exanthematous pustulosis (AGEP) is a reaction pattern mostly caused by drugs. It is characterized by the rapid occurrence of dozens to thousands pinhead-sized, non-follicular, sterile pustules on a slightly edematous erythematous base, commonly with accentuation in the major flexures and usually accompanied by a facial edema, fever and leukocytosis. Histology reveals spongiform subcorneal and/or intraepidermal pustules, an inflammatory infiltrate consisting of neutrophils and often eosinophils and frequently a marked edema of the papillary dermis.
Even if in single case reports a large number of drugs has been described as triggers for AGEP, larger studies have revealed a list with an elevated risk to cause the reaction which includes antibacterial agents like ampicillin/amoxicillin, quinolones, pristinamycin, anti-infective sulfonamides, the antimycotic drug terbinafine, (hydroxy)chloroquine, and diltiazem. In some cases infections have been reported as triggers.
CLINICAL COURSE, PROGNOSIS AND TREATMENT: AGEP is an acute and--especially in patients with concomitant diseases--sometimes severe reaction. Withdrawal of the causative agent usually leads to a rapid and complete resolution--even without further specific therapy.
急性泛发性脓疱性皮病（AGEP）是一种主要由药物引起的反应模式。其特征为在轻度水肿性红斑基础上迅速出现数十至数千个针头大小、非毛囊性、无菌性脓疱，常见于主要褶皱部位加重，通常伴有面部水肿、发热和白细胞增多。组织学显示海绵状角层下和/或表皮内脓疱，由中性粒细胞组成的炎症浸润，常伴有嗜酸性粒细胞，且乳头真皮常有明显水肿。
即使在个别病例报告中，大量药物被描述为AGEP的诱发因素，但更大规模的研究揭示了一份导致该反应风险升高的药物清单，其中包括抗菌药物如氨苄西林/阿莫西林、喹诺酮类、利福霉素、抗感染磺胺类、抗真菌药物特比萘芬、（羟基）氯喹和地尔硫䓬。在某些情况下，感染也被报告为诱发因素。
临床病程、预后和治疗：AGEP是一种急性反应，尤其是在伴有其他疾病的患者中，有时较为严重。停用致病药物通常会导致迅速且完全缓解，即使不进行进一步的特异性治疗也是如此。
