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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 67-year-old man developed a pruritic symmetrical non-follicular pustular eruption initially involving the dorsa of his hands and rapidly spreading to his forearms, arms, face, and trunk. Some days before, the patient had accidentally burned his hands. The wounds had been treated topically with two silver sulfadiazine creams, a nitrofurazone ointment and an impregnated gauze dressing. Patch tests were positive to all topicals and to their ingredients nitrofurazone, PEG 300, propylene glycol, polysorbate 80 and castor oil (Ricinus communis seed oil). This was a case of acute generalized exanthematous pustulosis-like allergic contact dermatitis. Which ingredient or ingredients were responsible is unknown (40).
Acute generalized pustular bacterid concomitant with erythema nodosum, polyarthritis, and Achilles tendinitis
Published in Modern Rheumatology, 2019
Yuki Arita, Hiroaki Taguchi, Ryota Hanada, Toshihiro Tono, Yasuo Ohsone, Utako Okata, Rie Irie, Yutaka Okano
The most probable clinical diagnosis was AGPB and EN. We performed a subsequent skin biopsy in order to confirm the diagnosis and obtained typical histopathological findings of AGPB and EN (Figure 2). Since one of the most prominent features was generalized pustulosis in her clinical manifestations, we focused on the differential diagnosis for other pustule diseases such as palmoplantar pustulosis (PPP), acute generalized exanthematous pustulosis (AGEP), and pustule psoriasis. Patients with PPP typically do not have systemic symptoms, such as high fever, and their lesions do not have the histopathological features of leukocytoclastic vasculitis. Patients with AGEP can have generalized plural pustules and histopathological findings of leukocytoclastic vasculitis, but eruption occurs suddenly within 48 h after the administration of drugs, for example, antibiotics, in many cases [2]. Patients with pustular psoriasis should have plaques of erythema. Since this patient had high fever, histological findings of LV, no prior drug administrations, and no plaques of erythema, we concluded that her skin lesions were AGPB. Bilateral Achilles tendinitis was observed on physical examination, but the enthesitis was not confirmed by imaging techniques. Therefore, she was finally diagnosed as having AGPB concomitant with EN and rheumatic manifestations such as polyarthritis and Achilles tendinitis.
Use of calcium channel blockers in dermatology: a narrative review
Published in Expert Review of Clinical Pharmacology, 2021
Yang Lo, Lian-Yu Lin, Tsen-Fang Tsai
The most common cutaneous adverse reactions to CCB are maculopapular rash, followed by ankle and pedal edema [81]. Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported occasionally [6,9,81], and these adverse reactions are more frequent with diltiazem than with other CCB [81]. As a matter of fact, all of the cutaneous reactions occur more frequently with diltiazem than with other CCB [82]. Several case reports of acute generalized exanthematous pustulosis (AGEP) and CCB have also been reported [81,83]. Moreover, cutaneous reactions due to cross-reactivity to different groups of CCB have been discussed frequently [84,85], which should be considered when dealing with adverse drug reactions from CCB.
Diagnosing and managing patients with drug hypersensitivity
Published in Expert Review of Clinical Immunology, 2018
Javier Fernandez, Inmaculada Doña
In the differential diagnosis of these severe cutaneous reactions, clinicians should also consider another entity, acute generalized exanthematous pustulosis (AGEP) [97], as well as defined dermatological entities such as erythema multiforme, erythroderma and erythematous drug eruptions, generalized bullous fixed drug eruption (FDE), phototoxic eruptions, staphylococcal scalded skin syndrome, paraneoplastic pemphigus, and linear IgA bullous dermatosis.