Severe flucloxacillin-induced acute generalized exanthematous pustulosis (AGEP), with toxic epidermal necrolysis (TEN)-like features: does overlap between AGEP and TEN exist? Clinical report and review of the literature

Br J Dermatol. 2014 Dec;171(6):1539-45. doi: 10.1111/bjd.13152. Epub 2014 Nov 9.

Abstract

Acute generalized exanthematous pustulosis (AGEP) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse drug reactions. Especially in TEN, large areas of the skin and mucosae may become detached. Although AGEP and SJS/TEN are distinct entities with a different clinical picture, pathogenesis, prognosis and treatment, they may share some features, raising the hypothesis of overlap between both entities. We present a severe case of AGEP, caused by flucloxacillin, clinically presenting with TEN-like features and pronounced systemic symptoms with haemodynamic and respiratory instability. Furthermore, we present a review of the literature on cases of AGEP with features resembling SJS/TEN or a supposed overlap with SJS/TEN.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Generalized Exanthematous Pustulosis / etiology*
  • Acute Generalized Exanthematous Pustulosis / pathology
  • Adult
  • Anti-Bacterial Agents / adverse effects*
  • Erysipelas / drug therapy
  • Female
  • Floxacillin / adverse effects*
  • Humans
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / pathology

Substances

  • Anti-Bacterial Agents
  • Floxacillin