Oral Prednisolone Induced Acute Generalized Exanthematous Pustulosis due to Corticosteroids of Group A Confirmed by Epicutaneous Testing and Lymphocyte Transformation Tests
- 1 June 2006
- journal article
- case report
- Published by S. Karger AG in Dermatology
- Vol. 213 (1), 40-43
- https://doi.org/10.1159/000092837
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption which is often provoked by drugs. We report 2 cases of AGEP which showed rapidly spreading pustular eruptions accompanied by malaise, fever and neutrophilia after the administration of systemic prednisolone (corticosteroid of group A, hydrocortisone type). The histological examination showing neutrophilic subcorneal spongiform pustules was consistent with the diagnosis of AGEP. In both cases the rash cleared within a week upon treatment with topical steroids (corticosteroid of group D1, betamethasonedipropionate type and corticosteroid of group D2, hydrocortisone-17-butyrate type). Three months after recovery, the sensitization to corticosteroids of group A was confirmed by epicutaneous testing and positive lymphocyte transformation tests. These cases show that systemic corticosteroids can induce AGEP and demonstrate that epicutaneous testing and lymphocyte transformation tests may be helpful in identifying the causative drug. Our data support previous reports indicating an important role for drug-specific T cells in inducing neutrophil inflammation in this disease.Keywords
This publication has 16 references indexed in Scilit:
- Ciprofloxacin-Induced Acute Generalized Exanthematous Pustulosis Mimicking Bullous Drug Eruption Confirmed by a Positive Patch TestDermatology, 2005
- The lymphocyte transformation test in the diagnosis of drug hypersensitivityAllergy, 2004
- Acute Generalized Exanthematic Pustulosis: A Case and an Overview of Side Effects Affecting the Skin Caused by Celecoxib and Other COX-2 Inhibitors Reported So FarDermatology, 2004
- T-cell involvement in drug-induced acute generalized exanthematous pustulosisJCI Insight, 2001
- Elevated serum levels of interleukins 5, 6, and 10 in a patient with drug-induced exanthem caused by systemic corticosteroidsJournal of the American Academy of Dermatology, 1998
- Patch testing in severe cutaneous adverse drug reactions, including Stevens‐Johnson syndrome and toxic epidermal necrolysisContact Dermatitis, 1996
- Corticosteroid contact allergy: an EECDRG multicentre studyContact Dermatitis, 1996
- Acute Generalized Exanthematous Pustulosis Induced by Dexamethasone InjectionDermatology, 1996
- Acute generalized exanthematous pustulosis. Analysis of 63 casesArchives of Dermatology, 1991