acute generalized exanthematous pustulosis
DESCRIPTION
Acute Generalized Exanthematous Pustulosis Presented byTRANSCRIPT
ACUTE ACUTE ACUTE ACUTE ACUTE ACUTE ACUTE ACUTE GENERALIZED GENERALIZED GENERALIZED GENERALIZED GENERALIZED GENERALIZED GENERALIZED GENERALIZED
EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS EXANTHEMATHOUS PUSTULOSISPUSTULOSISPUSTULOSISPUSTULOSISPUSTULOSISPUSTULOSISPUSTULOSISPUSTULOSIS
CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.CHULEEPORN KONGMEESOOK, M.D.
OutlineOutline
•• EpidemiologyEpidemiology
•• Clinical featuresClinical features
•• DiagnosisDiagnosis•• DiagnosisDiagnosis
•• TreatmentTreatment
EpidemiologyEpidemiology
•• UnreliableUnreliable
•• 11--5 cases per million per year5 cases per million per year
Alexis Alexis SidoroffSidoroff ChemChem ImmunolImmunol Allergy 2012;97:139Allergy 2012;97:139––148148
Clinical FeaturesClinical Features
•• Numerous, small nonNumerous, small non--follicular, follicular, intraepidermalintraepidermal or or subcornealsubcorneal pustules pustules
(<5 mm) on an (<5 mm) on an erythematouserythematous backgroundbackground
•• Typical Typical histopathologicalhistopathological changeschanges
•• Fever (> 38 Fever (> 38 °°C)C)•• Fever (> 38 Fever (> 38 °°C)C)
•• Blood Blood neutrophilneutrophil counts > 7 counts > 7 ×× 101099/L/L
•• Acute evolution with spontaneous Acute evolution with spontaneous resolution of pustules < 15 daysresolution of pustules < 15 days
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol 2010; 20 : 425Eur J Dermatol 2010; 20 : 425--3333
Alexis Alexis SidoroffSidoroff ChemChem ImmunolImmunol Allergy 2012;97:139Allergy 2012;97:139––148148
MajaMaja MockenhauptMockenhaupt JDDG 2009 ;7:142JDDG 2009 ;7:142––162162
www.regiscar.uniwww.regiscar.uni--freiburg.de/diseases/agepfreiburg.de/diseases/agep
Differential diagnosisDifferential diagnosis
•• PustularPustular psoriasispsoriasis
•• SubcornealSubcorneal pustularpustular dermatosisdermatosis
•• PustularPustular vasculitisvasculitis•• PustularPustular vasculitisvasculitis
Alexis Alexis SidoroffSidoroff et al et al J J CutanCutan PatholPathol 2001; 28:1132001; 28:113––119119
PustularPustular psoriasispsoriasis
www.dermis.netwww.dermis.net
SubcornealSubcorneal pustularpustular dermatosisdermatosis
www.uptodate.comwww.uptodate.com
PustularPustular vasculitisvasculitis
YoshihideYoshihide Asano et al Asano et al ActaActa DermDerm VenereolVenereol 2010;90:4202010;90:420--421421
HistopathologyHistopathology
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol Eur J Dermatol 20102010;;2020::425425--3333
EtiologyEtiology
•• Drugs Drugs ((90 90 %%))
•• InfectionsInfections
•• Other factors (spider bite, mercury, Other factors (spider bite, mercury, chemotherapy, herbal medicationschemotherapy, herbal medications))chemotherapy, herbal medicationschemotherapy, herbal medications))
Alexis Alexis SidoroffSidoroff ChemChem ImmunolImmunol Allergy Allergy 20122012;;9797::139139––148148SuranSuran L Fernando Australasian Journal of Dermatology L Fernando Australasian Journal of Dermatology 20122012; ; 5353: : 8787––9292
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol Eur J Dermatol 20102010;;2020::425425--3333SimaSima Halevy Halevy CurrCurr OpinOpin Allergy Allergy ClinClin ImmunolImmunol 20092009;;99::322322––328328
Alexis Alexis SidoroffSidoroff et al British Journal of Dermatology 2007;157: 989et al British Journal of Dermatology 2007;157: 989––996996
Alexis Alexis SidoroffSidoroff et al British Journal of Dermatology 2007;157: 989et al British Journal of Dermatology 2007;157: 989––996996
Alexis Alexis SidoroffSidoroff et al British Journal of Dermatology 2007;157: 989et al British Journal of Dermatology 2007;157: 989––996996
Alexis Alexis SidoroffSidoroff et al British Journal of Dermatology 2007;157: 989et al British Journal of Dermatology 2007;157: 989––996996
Alexis Alexis SidoroffSidoroff et al et al J J CutanCutan PatholPathol 2001; 28:1132001; 28:113––119119
Min Min JeeJee ChoiChoi et al Ann et al Ann DermatolDermatol 20102010;;2222::163163--169169
DiagnosisDiagnosis
•• Not standardized diagnostic toolsNot standardized diagnostic tools
Alexis Alexis SidoroffSidoroff ChemChem ImmunolImmunol Allergy 2012;97:139Allergy 2012;97:139––148148SuranSuran L Fernando Australasian Journal of Dermatology 2012; 53: 87L Fernando Australasian Journal of Dermatology 2012; 53: 87––9292
TreatmentTreatment
•• SelfSelf--limited diseaselimited disease
•• Discontinue causative drugDiscontinue causative drug
•• Systemic corticosteroid not necessarySystemic corticosteroid not necessary
•• Antibiotics if indicateAntibiotics if indicate
SuranSuran L Fernando Australasian Journal of Dermatology 2012; 53: 87L Fernando Australasian Journal of Dermatology 2012; 53: 87––9292Alexis Alexis SidoroffSidoroff et al et al J J CutanCutan PatholPathol 2001; 28:1132001; 28:113––119119
THANK YOUTHANK YOUTHANK YOUTHANK YOUTHANK YOUTHANK YOUTHANK YOUTHANK YOU
PathophysiologyPathophysiology
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol Eur J Dermatol 20102010; ; 20 20 : : 425425--3333
MajaMaja MockenhauptMockenhaupt JDDG JDDG 2009 2009 ;;77::142142––162162
MajaMaja MockenhauptMockenhaupt JDDG 2009 ;7:142JDDG 2009 ;7:142––162162
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol Eur J Dermatol 20102010;;2020::425425--3333
MarijnMarijn M. M. SpeeckaertSpeeckaert et al et al Eur J Dermatol Eur J Dermatol 20102010;;2020::425425--3333