Acute generalized exanthematous pustulosis induced by hydroxychloroquine: a case with atypical clinical presentation

Abstract

Acute generalized exanthematous pustulosis is a rare drug-induced eruption that is characterized by acute, nonfollicular sterile pustules on an erythematous and edematous base. The most frequently implicated drugs are beta-lactam antibiotics. Hydroxychloroquine has been widely used to treat dermatologic and rheumatologic diseases and has been reported as a rare cause of acute generalized exanthematous pustulosis. A 42-year-old female presented with pustular lesions on the skin surface with erythema, facial edema, and occasional atypical target-like lesions after 21 days of treatment with 200mg/day hydroxychloroquine for rheumatoid arthritis, diagnosed one month previously. We report a case with acute generalized exanthematous pustulosis induced by hydroxychloroquine and treated with dapsone and systemic corticosteroid.

A case of prolonged generalized exanthematous pustulosis caused by hydroxychloroquine—Literature review

“…Systemic corticosteroids are usually used for severe cases . Some authors have reported using dapsone and cyclosporine in treatment of severe and atypical forms of AGEP as case reports …”

“…We also reviewed the literature in English since 2008 to 2018 and found nine other cases . The details of the cases are summarized in Table .…”

“…4,5,7 Some authors have reported using dapsone and cyclosporine in treatment of severe and atypical forms of AGEP as case reports. 9,13 The pathogenesis of AGEP is not yet known although release of increased amount of IL 8 by T cells with attraction and activation of polymorphous nuclear neutrophils has recently been proposed. And the disease is associated with human leukocyte antigens B51, DR11, and DQ3.…”

“…7 We also reviewed the literature in English since 2008 to 2018 and found nine other cases. [7][8][9][10][11][12][13] The details of the cases are summarized in Table 1. The cases have been cleared within 8-91 days.…”

Hidroksiklorokinin tetiklediği akut generalize ekzantematöz püstülozis: Literatür eşliğinde bir olgu

“…(7,8). Bu yayınlarda ilaç başlandıktan 2-3 hafta içerisinde lezyonların geliştiği belirtilmiştir ve vakalardan 2 tanesi Türkiye'den bildirilmiştir (9,10).…”