Acute Generalized Exanthematous Pustulosis: AGEP

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a rare clinical entity characterized by an acute onset of numerous sterile, nonfollicular, pinhead-sized pustules arising on an erythematous, edematous base accompanied by fever (>38 C), neutrophilia, and occasionally eosinophilia. In 1968, Baker and Ryan reported 104 cases of pustular psoriasis and specifically detailed five patients whom they diagnosed as having “exanthematic pustular psoriasis” most likely due to a drug or infectious etiology. These five patients did not have a history of psoriasis and were characterized as having pustular skin reactions of acute onset that quickly resolved and did not recur. Subsequently, in 1980, Beylot et al. reviewed the existing literature regarding pustuloses and reported four additional cases; they are responsible for coining the name of this distinct entity as “acute generalized exanthematic pustulosis.” Additional literature reports by Macmillan in 1973 and Staughton and Harper in 1984 denote pustular skin eruptions most likely representing AGEP which they termed as “generalized pustular drug rash” and “toxic pustuloderma,” respectively.