title: Severe flucloxacillin-induced acute generalized exanthematous pustulosis (AGEP), with toxic epidermal necrolysis (TEN)-like features: does overlap between AGEP and TEN exist? Clinical report and review of the literature.
abstract: Acute generalized exanthematous pustulosis (AGEP) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse drug reactions. Especially in TEN, large areas of the skin and mucosae may become detached. Although AGEP and SJS/TEN are distinct entities with a different clinical picture, pathogenesis, prognosis and treatment, they may share some features, raising the hypothesis of overlap between both entities. We present a severe case of AGEP, caused by flucloxacillin, clinically presenting with TEN-like features and pronounced systemic symptoms with haemodynamic and respiratory instability. Furthermore, we present a review of the literature on cases of AGEP with features resembling SJS/TEN or a supposed overlap with SJS/TEN.
authors.affiliation: Department of Dermatology, Reference Center for Cutaneous Adverse Reactions, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ Groningen, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: van Hattem
authors.forename: G I
authors.initials: GI
authors.lastname: Beerthuizen
authors.forename: S H
authors.initials: SH
authors.lastname: Kardaun
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000209:etiology* / Q000473:pathology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D004886:Erysipelas / Q000188:drug therapy; D005260:Female; D005436:Floxacillin / Q000009:adverse effects*; D006801:Humans; D013262:Stevens-Johnson Syndrome / Q000209:etiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D005436:Floxacillin