Clindamycin-induced acute generalized exanthematous pustulosis: A case report.

RATIONALE

Acute generalized exanthematous pustulosis (AGEP) is a severe pustular cutaneous adverse drug reaction. Sterile, non-follicular pustules overlying the erythematous skin characterize this reaction.

PATIENT CONCERNS

A 30-year-old Asian women presented with sterile, non-follicular lesions with pus-fluid levels on her back 2 days after taking clindamycin. Skin biopsy revealed a spongiotic change in the epidermis with a focal subcorneal pustule and perivascular eosinophil and lymphocyte infiltration.

DIAGNOSIS

Clindamycin-induced AGEP.

INTERVENTIONS

We discontinued clindamycin treatment and prescribed systemic corticosteroids.

OUTCOMES

The pustule stopped spreading within 1 day and the rash improved within 2 days.

LESSONS

AGEP is a pustular cutaneous adverse drug reaction that can appear with pus-fluid levels, clinically mimicking Sneddon-Wilkinson disease. The differentiation between both conditions is a history of drug use, characteristic skin lesions and histopathology.