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- Kumpol Aiempanakit and Benjawan Apinantriyo.
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University.
- Medicine (Baltimore). 2020 May 22; 99 (21): e20389.
RationaleAcute generalized exanthematous pustulosis (AGEP) is a severe pustular cutaneous adverse drug reaction. Sterile, non-follicular pustules overlying the erythematous skin characterize this reaction.Patient ConcernsA 30-year-old Asian women presented with sterile, non-follicular lesions with pus-fluid levels on her back 2 days after taking clindamycin. Skin biopsy revealed a spongiotic change in the epidermis with a focal subcorneal pustule and perivascular eosinophil and lymphocyte infiltration.DiagnosisClindamycin-induced AGEP.InterventionsWe discontinued clindamycin treatment and prescribed systemic corticosteroids.OutcomesThe pustule stopped spreading within 1 day and the rash improved within 2 days.LessonsAGEP is a pustular cutaneous adverse drug reaction that can appear with pus-fluid levels, clinically mimicking Sneddon-Wilkinson disease. The differentiation between both conditions is a history of drug use, characteristic skin lesions and histopathology.
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