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Iomeprol-induced acute generalised exanthematous pustulosis (AGEP)
Prerana S Randive1, Suyog Dhamale1, Sahana Ojha2
1Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
BMJ Case Reports
|August 22, 2025
Summary
Acute generalised exanthematous pustulosis (AGEP), a severe drug reaction, can be triggered by iodinated contrast media like iomeprol. Early diagnosis and patch testing are key for managing this rare but serious condition.
Area of Science:
- Dermatology
- Pharmacology
- Radiology
Background:
- Acute generalised exanthematous pustulosis (AGEP) is a rare but severe cutaneous adverse drug reaction.
- Characterized by sudden onset of sterile pustules, fever, and leukocytosis.
- Typically drug-induced, but chemicals, dyes, or infections can also trigger it.
Purpose of the Study:
- To report a case of AGEP triggered by iodinated radiocontrast agent iomeprol.
- To highlight the importance of considering AGEP in patients exposed to iodinated contrast media.
- To emphasize early recognition and diagnostic strategies for AGEP management.
Main Methods:
- Case report of a woman in her 30s experiencing AGEP.
- Identification of iomeprol as the triggering agent.
- Discussion of diagnostic considerations, including patch testing.
Main Results:
- The patient presented with AGEP symptoms following exposure to iomeprol.
- Iodinated contrast media, though a rare cause, can precipitate AGEP.
- Patch testing is a valuable diagnostic tool for AGEP.
Conclusions:
- AGEP induced by iodinated contrast media is uncommon but clinically significant.
- Early diagnosis and appropriate management, including patch testing, are crucial.
- Awareness of this potential adverse reaction is vital for healthcare providers, especially during imaging studies.
