Pustular eruption after biosimilar rituximab infusion: report of acute generalized exanthematous pustulosis in two patients with pemphigus

2010 ◽

Vol 14 (4) ◽

pp. 181-184

Author(s):

Petra Cetkovská ◽

Nina Benáková

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem ◽

Pustular Eruption ◽

Immune Alteration ◽

Acute Generalized Exanthematous Pustulosis ◽

Cutaneous Adverse Reaction ◽

History Of ◽

Exanthematous Pustulosis

Background: A severe generalized pustular eruption occurred several months after allogeneic hematopoietic stem cell transplantation for multiple myeloma in a patient being treated with antibiotics for respiratory infection. Neither he nor his donor had a history of psoriasis. Methods: The patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone without improvement; later, acitretin and methylprednisolone were used successfully. The eruption slowly subsided, and therapy was discontinued. Four months later, the patient experienced a recurrent severe pustular eruption associated with fever and leukocytosis, and the same treatment was used successfully again. Results and Conclusion: The patient has not experienced relapses in the ensuing 3 years. Acute generalized exanthematous pustulosis is a rare cutaneous adverse reaction triggered most commonly by drugs with a tendency to resolve spontaneously. The surprisingly prolonged, refractory, and relapsing course of the eruption in our patient might be due to the immune alteration and the polypharmacologic therapy after stem cell transplantation. Antécédents: Une éruption pustulaire généralisée aiguë s'est produite chez un patient traité aux antibiotiques contre une infection respiratoire, plusieurs mois après une allogreffe de cellules souches hématopoïétiques pour myélome multiple. Ni le patient ni le donneur n'ont des antécédents de psoriasis.

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Steroid-resistant Acute Generalized Exanthematous Pustulosis Mimicking Generalized Pustular Psoriasis Successfully Treated by Methotrexate

Revista da Sociedade Portuguesa de Dermatologia e Venereologia ◽

10.29021/spdv.79.3.1327 ◽

2021 ◽

Vol 79 (3) ◽

pp. 257-260

Author(s):

Khairuddin Djawad

Keyword(s):

Inflammatory Cell ◽

Pustular Psoriasis ◽

Clinical Form ◽

Drug Induced ◽

Laboratory Findings ◽

Steroid Resistant ◽

Pustular Eruption ◽

Acute Generalized Exanthematous Pustulosis ◽

Generalized Pustular Psoriasis ◽

Exanthematous Pustulosis

Acute generalized exanthematous pustulosis is a rare drug-induced eruption that is characterized by sterile non-follicular pustules arising on an often edematous diffuse erythematous background. Generalized pustular psoriasis is an acute and severe clinical form of psoriasis presenting as pustular eruption with erythematous base. Differentiating both diseases is often challenging because of their clinical and histopathological similarities. A 62-year-old woman presented with pustular eruption and fever three days after taking propyphenazone. Laboratory findings revealed leukocytosis and neutrophilia. Histopathological findings revealed a subcorneal spongiform pustule filled with neutrophils and perivascular inflammatory cell infiltration with neutrophils in the dermis. She was initially treated with systemic steroids, however, the lesions showed insignificant improvement. Treatment was then shifted to methotrexate which resulted in a dramatic clinical improvement.

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Acute Generalized Exanthematous Pustulosis Induced by Olanzapine

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.114 ◽

2006 ◽

Vol 49 (1) ◽

pp. 75-76 ◽

Cited By ~ 5

Author(s):

Susanne Christen ◽

Félix Gueissaz ◽

Romain Anex ◽

Daniele Fabio Zullino

Keyword(s):

Whole Body ◽

Pustular Eruption ◽

Acute Generalized Exanthematous Pustulosis ◽

Exanthematous Pustulosis

The case of a 56 years old man is presented, who developed acute generalized exanthematous pustulosis 5 days after the introduction of olanzapine 10 mg. Multiple 1-mm pustules appeared on the whole body, concentrated especially on her neck and face. Within 2 days, the eruption was increasingly accompanied by erythema and pruritus. No fever, chills, nausea, vomiting, arthralgias or myalgias were recorded. The diagnosis was corroborated by hystopathology. After 7 days of treatment, olanzapine and valproate were stopped. Concomitantly, cetirizine 20mg p.o. and methylprednisolone 500 mg i.v. were given once. During the following week betamethasone cream was applied, and the pustular eruption resolved completely.

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