Acute generalized exanthematous pustulosis associated with clindamycin in a patient with Hailey-Hailey disease.

Autor: 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.
Jazyk: angličtina
Zdroj: Journal of cutaneous pathology [J Cutan Pathol] 2023 Oct; Vol. 50 (10), pp. 864-868. Date of Electronic Publication: 2023 Jul 10.
DOI: 10.1111/cup.14488
Abstrakt: 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.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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