Tags

Type your tag names separated by a space and hit enter

Acute generalized exanthematous pustulosis associated with clindamycin in a patient with Hailey-Hailey disease.
J Cutan Pathol. 2023 Oct; 50(10):864-868.JC

Abstract

A 61-year-old African-American female with moderately controlled Hailey-Hailey disease (HHD) presents to the emergency department with a rash and fever. One day prior to her presentation, she was started on oral clindamycin for a tooth extraction procedure. Her physical examination shows diffuse erythema on the trunk and extremities with multiple nonfollicular pustules. A punch biopsy of her upper extremity revealed intraepidermal acantholysis, neutrophilic spongiosis, and subcorneal pustules. The perivascular and interstitial superficial dermal infiltrate is mixed and composed of predominantly neutrophils, with lymphocytes and rare eosinophils. These findings suggest a superimposed acute generalized exanthematous pustulosis (AGEP) in the background of HHD. AGEP is a potentially severe cutaneous condition characterized by the abrupt onset of numerous nonfollicular pustules in a background of pruritic edematous erythroderma. To date, only two case reports have described AGEP in patients with HHD. Early diagnosis of AGEP is essential to initiate prompt and aggressive systemic therapy, prompt medication cessation, close monitoring for end-organ damage, and improve overall morbidity and mortality.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Casillas AC
Morehouse School of Medicine, Atlanta, Georgia, USA.
Barragan VA
Chicago Medical School, Rosalind Franklin University, North Chicago, Illinois, USA.
Alhalaseh Y
Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.
Modi MB
Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.
Lake E
Department of Dermatology, Loyola University Medical Center, Maywood, Illinois, USA.
Speiser JJ
Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.

MeSH

HumansFemaleMiddle AgedAcute Generalized Exanthematous PustulosisClindamycinPemphigus, Benign FamilialExanthemaSkin

Pub Type(s)

Case Reports

Language

eng

PubMed ID

37430411

Citation

Casillas, Austin C., et al. "Acute Generalized Exanthematous Pustulosis Associated With Clindamycin in a Patient With Hailey-Hailey Disease." Journal of Cutaneous Pathology, vol. 50, no. 10, 2023, pp. 864-868.
Casillas AC, Barragan VA, Alhalaseh Y, et al. Acute generalized exanthematous pustulosis associated with clindamycin in a patient with Hailey-Hailey disease. J Cutan Pathol. 2023;50(10):864-868.
Casillas, A. C., Barragan, V. A., Alhalaseh, Y., Modi, M. B., Lake, E., & Speiser, J. J. (2023). Acute generalized exanthematous pustulosis associated with clindamycin in a patient with Hailey-Hailey disease. Journal of Cutaneous Pathology, 50(10), 864-868. https://doi.org/10.1111/cup.14488
Casillas AC, et al. Acute Generalized Exanthematous Pustulosis Associated With Clindamycin in a Patient With Hailey-Hailey Disease. J Cutan Pathol. 2023;50(10):864-868. PubMed PMID: 37430411.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute generalized exanthematous pustulosis associated with clindamycin in a patient with Hailey-Hailey disease. AU - Casillas,Austin C, AU - Barragan,Victor A, AU - Alhalaseh,Yazan, AU - Modi,Mitul B, AU - Lake,Eden, AU - Speiser,Jodi J, Y1 - 2023/07/10/ PY - 2023/04/24/revised PY - 2023/02/22/received PY - 2023/06/13/accepted PY - 2023/9/11/medline PY - 2023/7/11/pubmed PY - 2023/7/11/entrez KW - Hailey-Hailey disease (HHD) KW - acute generalized exanthematous pustulosis (AGEP) KW - clindamycin KW - pustular dermatosis SP - 864 EP - 868 JF - Journal of cutaneous pathology JO - J Cutan Pathol VL - 50 IS - 10 N2 - A 61-year-old African-American female with moderately controlled Hailey-Hailey disease (HHD) presents to the emergency department with a rash and fever. One day prior to her presentation, she was started on oral clindamycin for a tooth extraction procedure. Her physical examination shows diffuse erythema on the trunk and extremities with multiple nonfollicular pustules. A punch biopsy of her upper extremity revealed intraepidermal acantholysis, neutrophilic spongiosis, and subcorneal pustules. The perivascular and interstitial superficial dermal infiltrate is mixed and composed of predominantly neutrophils, with lymphocytes and rare eosinophils. These findings suggest a superimposed acute generalized exanthematous pustulosis (AGEP) in the background of HHD. AGEP is a potentially severe cutaneous condition characterized by the abrupt onset of numerous nonfollicular pustules in a background of pruritic edematous erythroderma. To date, only two case reports have described AGEP in patients with HHD. Early diagnosis of AGEP is essential to initiate prompt and aggressive systemic therapy, prompt medication cessation, close monitoring for end-organ damage, and improve overall morbidity and mortality. SN - 1600-0560 UR - https://www.unboundmedicine.com/medline/citation/37430411/Acute_generalized_exanthematous_pustulosis_associated_with_clindamycin_in_a_patient_with_Hailey_Hailey_disease_ DB - PRIME DP - Unbound Medicine ER -