title: Rapid clearing of acute generalized exanthematous pustulosis after administration of ciclosporin.
abstract: Acute generalized exanthematous pustulosis (AGEP) is a rare disorder, usually drug-induced, and is clinically characterized by widespread, non-follicular aseptic pustules. Although spontaneous resolution usually occurs once the causative drug has been withdrawn, more severe cases often require treatment with systemic corticosteroids. We report a 63-year-old woman who developed AGEP after a 30-day course of hydroxychloroquine. Extensive re-exacerbation of AGEP after an 18-day course of methylprednisolone led us to switch the treatment to oral ciclosporin with a prompt and satisfactory improvement. Ciclosporin has many inhibitory effects on the main cell population (T cells) involved in AGEP. In particular, a significant reduction in production of interleukin-8 by T cells is a possible explanation of the rapid remission observed in this case. To our knowledge, this is the first reported case of AGEP successfully treated with ciclosporin.
authors: Department of Dermatology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. vito.dilernia@asmn.re.it
authors: V
authors: V
authors: Di Lernia
authors: L
authors: L
authors: Grenzi
authors: E
authors: E
authors: Guareschi
authors: C
authors: C
authors: Ricci
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use*; D005076:Exanthema / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D006886:Hydroxychloroquine; D016572:Cyclosporine