title: Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy.
abstract: Acute generalized exanthematous pustulosis (AGEP) is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base and spontaneous resolution usually within two weeks. Systemic involvement occurs in about 20% of cases. The course is mostly benign, and only in rare cases complications lead to life-threatening situations. Recent studies highlight the importance of genetic variations in interleukin-36 receptor antagonist gene (IL-36RN) in the pathogenesis of this disease. The physiopathology of AGEP remains unclear, but an involvement of innate and acquired immune cells together with resident cells (keratinocytes), which recruit and activate neutrophils via production of cytokines/chemokines such as IL-17, IL-36, granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNFα) and chemokine (C-X-C motif) ligand 8 (CXCL8)/IL-8, has been postulated. Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids.
authors.affiliation: Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland. laurence.feldmeyer@insel.ch.
authors.forename: Laurence
authors.initials: L
authors.lastname: Feldmeyer
authors.affiliation: Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland. Kristine.Heidemeyer@insel.ch.
authors.forename: Kristine
authors.initials: K
authors.lastname: Heidemeyer
authors.affiliation: Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland. Nikhil.Yawalkar@insel.ch.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Yawalkar
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation / Q000235:genetics*; D006801:Humans
keywords: acute generalized exanthematous pustulosis; dermatology; drug reaction; skin