Nusbaum Kelsey B, Walker Trent D, Himed Sonia, Trinidad John Christopher, Spaccarelli Natalie, Chung Catherine, Kaffenberger Benjamin H
University of Cincinnati College of Medicine, Cincinnati, OH, USA.
College of Medicine, The Ohio State University, Columbus, OH, USA.
Am J Clin Dermatol. 2023 Mar;24(2):299-304. doi: 10.1007/s40257-022-00737-5. Epub 2022 Oct 28.
Current understanding of the etiology, natural history, and outcomes of acute generalized exanthematous pustulosis (AGEP) has been limited, with most available studies consisting of small or heterogenous cohorts.
The aim of this study was to further characterize associated factors and disease outcomes of AGEP.
A cross-sectional study design was employed with formal inclusion and causality criteria. Patients were identified from an inpatient database at an academic medical center, including 65 patients with AGEP and a control group of 61 patients with non-severe cutaneous adverse reactions.
Increased age and body mass index (BMI) were associated with higher risk of AGEP (p < 0.001). Length of stay was longer for both the overall AGEP cohort (13.1 days) and a subcohort with a primary discharge diagnosis of AGEP (9.7 days) compared with the control group (3.6 days) [p < 0.001]. Patients with AGEP were more likely to be discharged to a long-term care facility compared with control patients (p < 0.001).
AGEP was associated with longer length of hospitalization, higher rates of discharge to long-term care facilities, and higher mortality compared with non-severe cutaneous adverse drug reaction (SCAR) medication reactions. Future research should examine the association between morbid obesity and this particular drug reaction, and the possibility of decreasing hospitalization length given the relatively low risk of mortality among patients with AGEP.
目前对急性泛发性脓疱性皮病(AGEP)的病因、自然史和结局的了解有限,大多数现有研究由规模较小或异质性队列组成。
本研究的目的是进一步描述AGEP的相关因素和疾病结局。
采用横断面研究设计,并制定了正式的纳入标准和因果关系标准。从一所学术医疗中心的住院患者数据库中识别患者,包括65例AGEP患者和一个由61例非严重皮肤不良反应患者组成的对照组。
年龄增加和体重指数(BMI)升高与AGEP风险增加相关(p < 0.001)。与对照组(3.6天)相比,AGEP总体队列(13.1天)和以AGEP作为主要出院诊断的亚队列(9.7天)的住院时间更长[p < 0.001]。与对照患者相比,AGEP患者更有可能出院后入住长期护理机构(p < 0.001)。
与非严重皮肤药物不良反应(SCAR)药物反应相比,AGEP与更长的住院时间、更高的长期护理机构出院率和更高的死亡率相关。未来的研究应探讨病态肥胖与这种特定药物反应之间的关联,以及鉴于AGEP患者死亡率相对较低而缩短住院时间的可能性。