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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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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...
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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Hydroxychloroquine-induced acute generalized exanthematous pustulosis with positive patch-testing.

Ons Charfi1, Sarrah Kastalli2, Rym Sahnoun2

  • 1Department of Pharmacology, National Center of Pharmacovigilance, 9 Avenue du Dr Zouhaier Essafi 1006, Tunis, Tunisia.

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Acute generalized exanthematous pustulosis (AGEP), a severe skin reaction, can be triggered by hydroxychloroquine. This case highlights hydroxychloroquine-induced AGEP with systemic effects, confirmed by patch testing.

Keywords:
Hydroxychloroquinepatch testpustulosis

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Area of Science:

  • Dermatology
  • Pharmacology
  • Toxicology

Background:

  • Acute generalized exanthematous pustulosis (AGEP) is a severe, drug-induced skin reaction characterized by widespread pustules.
  • While numerous drugs can trigger AGEP, hydroxychloroquine is an infrequently reported cause.

Observation:

  • A case of AGEP is presented, which was induced by hydroxychloroquine.
  • The patient exhibited systemic involvement in addition to the cutaneous manifestations.

Findings:

  • Hydroxychloroquine was identified as the causative agent for AGEP in this patient.
  • Positive patch testing confirmed the hypersensitivity to hydroxychloroquine.

Implications:

  • This case expands the spectrum of known drug-induced AGEP.
  • It underscores the importance of considering hydroxychloroquine in the differential diagnosis of AGEP, especially with systemic features.