Acute Generalized Exanthematous Pustulosis in a Setting of Cutaneous Lymphoma

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 9
• Main Authors: Budh, Deepa P, Hawa, Saadiya, Rios, Daniele, Chilakala, Akhila, Paniagua, Julian A
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 29-09-2022; Cureus
• Subjects: Allergy/Immunology; Antibiotics; Blood vessels; Cardiovascular disease; Case reports; Dermatology; Edema; Emergency medical care; Erythema; Fever; Histology; Hospitals; Immunoglobulins; Infections; Internal Medicine; Lymphoma; Monoclonal antibodies; Morphology; Neutrophils; Pathology; Psoriasis; Ulcers; United States > US
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.29754

Acute generalized exanthematous pustulosis (AGEP) is a rare dermatological manifestation of the adverse drug reaction that occurs for a varied duration after the receipt of certain drugs. It manifests as an acute onset of generalized exanthematous pustular reaction with an edematous base. It has a characteristic clinical presentation and rapid resolution soon after the removal of the offending drug. The unique histological finding is that of single-cell necrosis of keratinocytes with edema of papillary dermis accompanied by components of vasculitis and/or exocytosis of eosinophils. Management consists of moist antiseptic dressings, topical steroids, infliximab, the use of systemic steroids if needed, and avoiding antibiotics as much as possible. Here, we present a case of AGEP in a setting of usages of antibiotics like vancomycin, cefepime, and ceftriaxone in a patient with cutaneous lymphoma that resolved after withdrawal of the offending antibiotics.