scholarly journals The Confusion between Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis as a Cause of Exfoliative Dermatitis: A Case Report

2021 ◽  
Vol 33 (3) ◽  
pp. 224
Author(s):  
Desiana Widityaning Sari ◽  
Cita Rosita Sigit Prakoeswa ◽  
Damayanti Damayanti ◽  
Sylvia Anggraeni ◽  
Menul Ayu Umborowati ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Clinical Manifestations ◽  
Clinical Findings ◽  
Pustular Psoriasis ◽  
History Taking ◽  
Exfoliative Dermatitis ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Physical Examinations ◽  
Erythematous Skin ◽  
Exanthematous Pustulosis

Background: Pustular psoriasis and Acute Generalized Exanthematous Pustulosis (AGEP) are grouped under pustular diseases, in which their clinical manifestations are similar. Those diseases can lead to exfoliative dermatitis. Purpose:To evaluate a specific histopathological examination in differentiating Pustular Psoriasis and AGEP. Case: A 55-year-old woman presented with sudden redness and diffused scaly skin with multiple pustules and also fever. She had taken Cefadroxil 2 days before the scales and pustules appeared. Leukocytosis and histopathological examination results from biopsy supported the diagnosis of AGEP. The patient was then hospitalized and received steroid therapy. Within the first week of tapering off, the scales disappeared but the pustules increased. After such clinical findings, the histopathological examination results were revisited and reassessed. Thus, we considered changing the diagnosis to Pustular Psoriasis, and the therapy was switched to Methotrexate. The patient had a better outcome, and the pustules slowly disappeared entirely. Discussion: It is often difficult to differentiate between the pustules in pustular psoriasis and AGEP unless by thorough history-taking and physical examinations. AGEP is characterized by a widespread of pustules with an acute febrile onset; while pustular psoriasis is an acute variant of psoriasis where pustules are spread over erythematous skin and accompanied by high fever and leukocytosis. Conclusion: Histopathological examination is the gold standard for the establishment of pustular psoriasis diagnosis. The histopathological characteristics of pustular psoriasis and AGEP are difficult to differentiate. Therefore, we need detailed history-taking and physical examination to establish the diagnosis.

scholarly journals An Uncommon Side Effect of Bupropion: A Case of Acute Generalized Exanthematous Pustulosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Hasan Tak ◽  
Cengiz Koçak ◽  
Gülben Sarıcı ◽  
Nazlı Dizen Namdar ◽  
Mehtap Kıdır
Keyword(s):  
Smoking Cessation ◽  
Side Effect ◽  
Pustular Psoriasis ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Inflammatory Dermatosis ◽  
Rare Side Effect ◽  
Erythematous Skin ◽  
Exanthematous Pustulosis

Acute generalized exanthematous pustulosis (AGEP) is a rare inflammatory dermatosis characterized by multiple nonfollicular pustules that occur on erythematous skin. Despite its similarity to pustular psoriasis and association with fever and leukocytosis, AGEP typically heals quickly. Etiologically, drugs and viruses have been suspected in most cases. Here, we present a case of AGEP, in a woman, that developed 1 day after starting bupropion for smoking cessation, as a rare side effect of the treatment.

scholarly journals Histopathologic interpersonal overview of generalized pustular cutaneous reaction to Hydroxychloroquine (HCQ): New challenging clinical manifestation

2021 ◽  
Vol 15 (6) ◽  
pp. 2102-2106
Author(s):  
Alireza Ghanadan ◽  
Zahra Naraghi ◽  
Kambiz Kamyab- Hesari ◽  
Azita Nikoo ◽  
Zahra Halaji ◽  
...  
Keyword(s):  
Clinical Judgment ◽  
Lymphocytic Infiltration ◽  
Final Diagnosis ◽  
Pustular Psoriasis ◽  
Cutaneous Eruption ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Clinical Presentations ◽  
Diagnostic Report ◽  
Exanthematous Pustulosis ◽  
Pathology Review

Background: Pathologic examination of Acute Generalized Exanthematous Pustulosis (AGEP) and Pustular Psoriasis (PP) are similar. We encountered many patients with PP or AGEP who cannot be distinguished clinically, pathologically and based on disease course from each so we designed a comprehensive interpersonal histopathologic overview of these patients' samples. Method: Histopathological data of 16 patients over 3.5 years were analyzed. Four pathologists separately reviewed specimens based on eighteen criteria (9 Epidermal and 9 Dermal). Severity score for each criterion was considered as to be (0 to 3+). We compared the final pathologic diagnosis with primary one. Results: Neutrophilic and lymphocytic infiltration in dermis were seen in all cases of AGEP while intraepithelial pustules. Subcorneal and intraepithelial pustules, spongiosis, neutrophilic exocytosis, neutrophilic and lymphocytic infiltration in dermis were observed in all cases of PP. The most severe neutrophilic inflammation; acanthosis and neutrophilic or lymphocytic infiltration were seen in PP. The authors of this study have been reported generalized pustular clinical presentations of patients have been taken HCQ, and in the recent pandemic it is also one of the concerns that many studies have been focused (....). Conclusion: When primary histopathologic report is AGEP/PP overlap, clinical judgment is the best way to manage and it is more probable that the final diagnosis being PP. When only AGEP or PP is histopathologic diagnostic report, it is usually enough to make final diagnosis and appropriate management. Key words: hydroxychloroquine, HCQ, generalized pustular cutaneous eruption, Pustular Psoriasis (PP), Acute Generalized Exanthematous Pustulosism, AGEP, Histopathological overview, pathology, review

scholarly journals Acute generalized exanthematous pustulosis x Von Zumbusch’s pustular psoriasis: A diagnostic challenge in a psoriatic patient

2015 ◽  
Vol 90 (4) ◽  
pp. 557-560 ◽  
Author(s):  
Aline Soares de Sousa ◽  
Osório Alves Corrêa de Castro Lara ◽  
Francine Papaiordanou ◽  
Gláucia Silva Simioni Marchioro ◽  
Antonio José Tebcherani
Keyword(s):  
Pustular Psoriasis ◽  
Psoriatic Patient ◽  
Diagnostic Challenge ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Exanthematous Pustulosis

A comparison of Ki-67 antigen presentation in acute generalized exanthematous pustulosis and pustular psoriasis

2010 ◽  
Vol 302 (7) ◽  
pp. 525-529 ◽  
Author(s):  
Shyue-Luen Chang ◽  
Sindy Hu ◽  
Shuen-Iu Hung ◽  
Yau-Li Huang ◽  
Wen-chin Hsiao ◽  
...  
Keyword(s):  
Antigen Presentation ◽  
Pustular Psoriasis ◽  
Ki 67 ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Exanthematous Pustulosis

scholarly journals Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1004
Author(s):  
Morgan Sussman ◽  
Anthony Napodano ◽  
Simo Huang ◽  
Abhirup Are ◽  
Sylvia Hsu ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Clinical Course ◽  
Pustular Psoriasis ◽  
Topical Steroids ◽  
Inflammatory Disorder ◽  
Acute Generalized Exanthematous Pustulosis ◽  
Cutaneous Adverse Reaction ◽  
History Of ◽  
Exanthematous Pustulosis ◽  
Crucial Part

The similarity between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP) poses problems in the diagnosis and treatment of these two conditions. Significant clinical and histopathologic overlap exists between PP and AGEP. PP is an inflammatory disorder that has numerous clinical subtypes, but all with sterile pustules composed of neutrophils. AGEP is a severe cutaneous adverse reaction that is also characterized by non-follicular sterile pustules. Clinical features that suggest a diagnosis of PP over AGEP include a history of psoriasis and the presence of scaling plaques. Histologically, eosinophilic spongiosis, vacuolar interface dermatitis, and dermal eosinophilia favor a diagnosis of AGEP over PP. Importantly, PP and AGEP vary in clinical course and treatment. PP treatment involves topical steroids, oral retinoids, and systemic immunosuppressants. Newer therapies targeting IL-36, IL-23, IL-1, and PDE-4 have been investigated. The removal of the offending agent is a crucial part of the treatment of AGEP.

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