title: Severe Cutaneous Drug Reactions: Do Overlapping Forms Exist?
abstract: Acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms are all severe hypersensitivity reactions to medications. While each of these reactions is a well-established entity with specific diagnostic criteria, clinicians see cases that fulfill criteria for more than one form, prompting discussion on the possibility of combined forms. Such overlapping clinical pictures meeting the criteria for 2 conditions have thus become a topic of debate in dermatology in recent years. We describe 2 patients with cutaneous drug reactions having the characteristics of both acute generalized exanthematous pustulosis and Stevens-Johnson syndrome -toxic epidermal necrolysis. We also review previously published cases and current thinking on such overlapping conditions.
authors.affiliation: Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: celiahr@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Horcajada-Reales
authors.affiliation: Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Pulido-Pérez
authors.affiliation: Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Suárez-Fernández
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis*; D004802:Eosinophilia / Q000150:complications; D005260:Female; D006801:Humans; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis*
keywords: Acute generalized exanthematous pustulosis; Cutaneous adverse drug reactions; Necrólisis epidérmica tóxica; Pustulosis exantemática generalizada aguda; Stevens-Johnson syndrome; Síndrome de Stevens-Johnson; Toxic epidermal necrolysis; Toxicodermias