Acute generalized exanthematous pustulosis due to clindamycin

Area of Science:

• Dermatology
• Pharmacology

Background:

• Acute generalized exanthematous pustulosis (AGEP) is a rare, severe cutaneous adverse drug reaction.
• It typically presents with fever and widespread non-follicular pustules on erythematous skin.

Observation:

• This report details a case of clindamycin-induced AGEP in a patient with a history of multiple drug allergies.
• The patient had no prior history of psoriasis, a condition sometimes associated with AGEP.

Findings:

• Histopathology revealed characteristic subcorneal pustules, dermal edema, spongiosis, leukocytoclastic vasculitis, and eosinophilic infiltration.
• Clindamycin was identified as the likely causative agent, despite the patient's extensive drug sensitivities.

Implications:

• This case expands the understanding of AGEP triggers and clinical presentations.
• It underscores the importance of considering AGEP in patients with multiple drug allergies presenting with acute pustular eruptions.
• Reviewing the presentation and treatment of AGEP is crucial for effective patient management.