Acute generalized exanthematous pustulosis caused by vareniclineEditor Varenicline is a new product indicated for smoking cessation. Cutaneous side-effects are rare. To our knowledge, we report the first case of severe drug-induced eruption in the form of acute generalized exanthematous pustulosis (AGEP) induced by varenicline.A 41-year-old woman smoker (25 packs per year) was treated with varenicline for the purpose of smoking cessation. Five days later, a submammary erythema appeared and rapidly spread to the trunk and the extremities despite discontinuation of the treatment. The patient was referred to our clinic 2 days later. She had fever of 39.2 °C and asthenia. There was a diffuse pruritic rash with intense erythema of the trunk and skin folds covered with pustular lesions, oedematous facial involvement, maculopapular and vesiculopustular lesions of the extremities with palmoplantar pseudo-dyshydrosis (Figs 1, 2). There were inguinal and axillary centimetric adenopathies. There was no involvement of mucous membranes, Nikolski's sign or bullous lesion. The rest of the physical examination was unremarkable.The laboratory tests revealed leukocytosis of 24 700/mm 3 with 21 700 neutrophils and 1000 eosinophils. The level of C-reactive protein was elevated at 223 mg/L. The renal and hepatic functions were normal. The bacteriological samples were sterile. Serological LETTERS TO THE EDITOR

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