title: Acute generalized exanthematous pustulosis: clinical characteristics, etiologic associations, treatments, and outcomes in a series of 28 patients at Mayo Clinic, 1996-2013.
abstract: BACKGROUND
  Acute generalized exanthematous pustulosis (AGEP) is a rare skin condition typically caused by medications. The objective of this study was to examine the clinical features, causes, and outcomes of AGEP at a sole tertiary care center.
  
  
  METHODS
  A retrospective review of patients with AGEP (European Study of Severe Cutaneous Adverse Reactions score of ≥ 5) seen at Mayo Clinic (Rochester, MN, USA) between January 1, 1996, and December 31, 2013, was conducted.
  
  
  RESULTS
  Of 28 patients (mean age at onset: 56 years), 17 (61%) were women. The development of AGEP was attributed to medications in 25 patients (89%), with clindamycin the most common culprit (six patients). Three patients (11%) had mucous membrane involvement, and 21 (75%) showed systemic involvement. Ten patients (36%) received systemic corticosteroids for treatment of AGEP. Skin findings resolved within 15 days in 26 patients (93%) (mean time to resolution: 7.6 days). In three patients (11%), generalized skin eruptions or dermatitis developed weeks to months after the resolution of AGEP. Twenty-four patients (86%) had a personal history of drug reactions before the development of AGEP.
  
  
  CONCLUSIONS
  A previous history of drug reactions and clindamycin causation were more common in the present cohort than in prior reports. A small subset of patients experienced new-onset non-AGEP skin eruptions within a few months of the resolution of AGEP.
authors.affiliation: Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Dema T
authors.initials: DT
authors.lastname: Alniemi
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Wetter
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.|Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Alina G
authors.initials: AG
authors.lastname: Bridges
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rokea A
authors.initials: RA
authors.lastname: El-Azhary
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mark D P
authors.initials: MD
authors.lastname: Davis
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.|Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Camilleri
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Marian T
authors.initials: MT
authors.lastname: McEvoy
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002981:Clindamycin / Q000009:adverse effects; D003872:Dermatitis / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D005446:Fluocinolone Acetonide / Q000031:analogs & derivatives / Q000627:therapeutic use; D005447:Fluocinonide / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005446:Fluocinolone Acetonide; D014221:Triamcinolone; D005447:Fluocinonide; D002981:Clindamycin; C035394:fluocinolone; D011241:Prednisone; D006854:Hydrocortisone