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Related Concept Videos

Acne Infection01:27

Acne Infection

Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
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Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum sickness, a systemic...
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Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
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Granulocyte-dependent Autoantibody-induced Skin Blistering
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Granulocyte-dependent Autoantibody-induced Skin Blistering

Published on: October 12, 2012

Acute generalised exanthematous pustulosis.

Suran L Fernando1

  • 1Department of Clinical Immunology, Royal North Shore Hospital, PaLMS Immunorheumatology Laboratory and Northern Clinical School, Sydney University, Sydney, New South Wales, Australia. sfernando@nsccahs.health.nsw.gov.au

The Australasian Journal of Dermatology
|May 11, 2012
PubMed
Summary
This summary is machine-generated.

Acute generalised exanthematous pustulosis (AGEP) is a severe drug-induced skin reaction characterized by fever and pustules. Prompt withdrawal of the offending drug typically resolves AGEP, though corticosteroids may be needed.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Immunology

Background:

  • Acute generalised exanthematous pustulosis (AGEP) is a rare but severe cutaneous adverse drug reaction.
  • It affects 1-5 per million individuals annually, primarily triggered by medications in over 90% of cases.

Purpose of the Study:

  • To review the clinical presentation, pathogenesis, diagnosis, and management of AGEP.
  • To identify high-risk drugs associated with AGEP development.

Main Methods:

  • Literature review of AGEP cases and associated drug triggers.
  • Analysis of pathomechanisms involving T-cells and neutrophils.
  • Review of diagnostic methods including histology and patch testing.

Main Results:

  • AGEP presents with fever and widespread sterile pustules 3-5 days post-drug initiation, marked by neutrophilia.
  • High-risk drugs include aminopenicillins, hydroxychloroquine, and terbinafine.
  • Pathogenesis involves CD8 T-cell influx, keratinocyte apoptosis, and subsequent neutrophil-driven inflammation.

Conclusions:

  • AGEP diagnosis is supported by characteristic histology and patch testing.
  • Withdrawal of the causative agent is the primary treatment, with corticosteroids used in some cases.
  • Mortality is low (up to 5%), predominantly in elderly patients with comorbidities.