急性泛发性发疹性脓疱性皮病1例

报告1例急性泛发性发疹性脓疱病。患者女，75岁，躯干、四肢起红斑，部分融合成大片，其上密集分布粟粒至米粒大的脓疱，部分脓疱互相融合成“脓湖”，右下肢部分片状脱屑。组织病理示角层下脓疱。患者在发疹前2h使用过青霉素等药物。     

Acute generalized exanthematous pustulosis due to terbinafine

Acute generalized exanthematous pustulosis is a rare adverse cutaneous reaction characterized by the rapid appearance of numerous pustules arising on edematous, erythematous skin. It is commonly accompanied by fever and leukocytosis and usually resolves with discontinuation of the offending agent. Herein, acute generalized exanthematous pustulosis induced by terbinafine is described, followed by a brief review of the literature.     

Acute generalized exanthematous pustulosis due to thallium

Acute generalized exanthematous pustulosis (AGEP) is characterized clinically by fever, pruritus and acute pustular eruption. Usually a drug is found to be the responsible agent. We present a patient who experienced an acute generalized exanthematous pustulosis due to radioactive thallium. The eruption cleared rapidly after discontinuation of the drug and systemic corticosteroid therapy.     

Acute generalized exanthematous pustulosis in a six-year-old boy

Acute generalized exanthematous pustulosis (AGEP) presents with an abrupt onset of widespread pustules on erythematous base and rapid spontaneous healing. AGEP may have a variety of causative factors such as drugs, viral infection and exposure to mercury. We report a case of AGEP in a 6-year-old boy who presented with acute onset of fever and widespread pustular eruption on erythematous bases. Histologic examination showed neutrophilic subcorneal spongiform pustule. It is an uncommon condition in children.     

Acute generalized exanthematous pustulosis induced by ingestion of bamifylline

We report a case of acute generalized exanthematous pustulosis (AGEP) in a 64-year-old woman, associated with the use of bamifylline. To the best of our knowledge there have been no previous reports of AGEP induced by the ingestion of bamifylline in the medical literature. We, therefore, add this drug to the list of causes for AGEP.     

急性泛发性发疹性脓疱病14例临床分析

本文分析了14例急性泛发性发疹性脓疱病的一般资料、临床表现和治疗情况。14例患者中11例有用药史,全部有发热,皮疹为弥漫性红斑、非毛囊性脓疱,予以糖皮质激素等对症治疗,所有患者2周内痊愈。     

Acute generalised exanthematous pustulosis

Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction and is caused by drugs in >90% of cases. It is rare, with an incidence of 1-5 patients per million per year. The clinical manifestations are characterised by fever and the rapid appearance of disseminated sterile pustules 3-5 days after the commencement of treatment. It is accompanied by marked neutrophilia. Mucous membranes are not typically involved. The drugs conferring the highest risk of AGEP according to the EuroSCAR study are aminopenicillins, pristinamycin, hydroxychloroquine, antibacterial sulphonamides, terbinafine and diltiazem. The pathogenesis of AGEP involves the initial influx of CD8 cytotoxic T-cells resulting in the apoptosis of keratinocytes and formation of vesicles. Then CXCL-8-producing and granulocyte macrophage-colony stimulating factor-producing CD4 cells enter the epidermis, resulting in neutrophil mediated inflammation and the formation of pustules. As a result, the histology reveals intraepidermal, usually subcorneal, pustules and an accompanying neutrophilic and lymphocytic infiltrate. Epicutaneous patch testing may also support the diagnosis by causing a localised pustular reaction 48-96 h after the offending drug is applied. The condition usually resolves by 15 days after the causative drug is withdrawn but oral corticosteroid therapy may be necessary in some individuals. The mortality rate is up to 5% and mostly occurs in elderly people who have significant comorbidities.