Etiopathological and clinical study of acute generalized exanthematous pustulosis: Experience from a tertiary care hospital in North India

What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature

“…Her family members became sick at the same time, bringing up the possibility of a viral infection (which is also reported as a causative factor of AGEP). 2,8 She also visited the country area where rickettsiosis is an endemic disease, and it shares some clinical features with AGEP. Moreover, the patient had received the mRNA Pfizer vaccination less than 4 weeks before the symptoms occurred, and vaccination is also reported as a cause of AGEP.…”

“…reaction in a few hours, to trunk, abdomen, legs, arms, and face, and in about 20% of times, it may develop also in mucous membranes, especially oral mucosa. 2,7 Itching and a burning sensation may also be present. AGEP is caused by systemic drugs in about 90% of the cases, 1 while in less than 10% of cases it is triggered by food allergy, contact dermatitis, viral infections, mercury exposition 8 vaccines, and insect bites.…”

“…2 It is not uncommon to see AGEP overlap with other severe cutaneous reactions such as toxic epidermal necrolysis (TEN) or Steven Johnson's Syndrome (STJ). 2 The yearly incidence of AGEP is around 1-5 cases per million and it is more common in women. 2 The first attempt to organise the diagnostic criteria of AGEP was introduced by Roujeau et al 7 : (1) non-follicular pustules (<5 mm) arising on widespread edematous erythema, (2) subcorneal and intraepidermal pustules accompanied by dermal edema and perivascular neutrophils or eosinophils infiltrate on histology, (3) fever >38°C, (4) blood neutrophils greater than 7 × 10 9 /L, and finally (5) the acute onset followed by spontaneous resolution of pustules in less than 15 days.…”

“…2 The yearly incidence of AGEP is around 1-5 cases per million and it is more common in women. 2 The first attempt to organise the diagnostic criteria of AGEP was introduced by Roujeau et al 7 : (1) non-follicular pustules (<5 mm) arising on widespread edematous erythema, (2) subcorneal and intraepidermal pustules accompanied by dermal edema and perivascular neutrophils or eosinophils infiltrate on histology, (3) fever >38°C, (4) blood neutrophils greater than 7 × 10 9 /L, and finally (5) the acute onset followed by spontaneous resolution of pustules in less than 15 days. 7 Later, Sidoroff et al 9 have reviewed those criteria based on morphological and histological criteria to validate the AGEP score during an important study on drug eruptions (Euroscar).…”

Oxford‐AstraZeneca COVID‐19 vaccine‐induced acute localized exanthematous pustulosis

“…Reports on vaccine‐induced ALEP/AGEP are limited. Previous case reports include four cases of AGEP, induced by the measles–mumps–rubella, diphtheria–pertussis–tetanus, and pneumococcal vaccines in an American child; 2 influenza vaccine in a pregnant Japanese woman; 3 tetanus toxoid vaccine in an Indian patient; 4 and AZD1222 vaccine in a Korean woman. 5 …”