TY - JOUR
T1 - Acute generalized exanthematous pustulosis (AGEP) following intake of furosemide
AU - Davidovici, Batya B.
AU - Naveh, Hadas Prag
AU - Cagnano, Emanuella
AU - Halevy, Sima
PY - 2006/7
Y1 - 2006/7
N2 - Introduction: Acute generalized exanthematous pustulosis (AGEP) is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. The causative agents are mostly drugs but other triggers have also been described. Case report: A 52 year-old woman with a history of diabetes mellitus type II, dyslipidemia and osteomyelitis was treated for about a year with metformin (Glucophage®) and simvastatin (Simovil®) tablets. Due to the osteomyelitis, the patient was started on a regimen of intravenous vancomycin as well as furosemide tablets (Fusid®) for pedal edema. About seventeen days after beginning treatment with vancomycin and a week after starting furosemide the patient was hospitalized due to an acute pruritic pustular eruption, involving most of her body surface area. Both vancomycin and furosemide treatment were discontinued, and topical treatment was provided. The clinical course was rapid with spontaneous resolution of the pustules followed by a characteristic pin-point post-pustular desquamation. The morphological, clinical and histological findings suggested a definite case of AGEP based on the EuroSCAR scoring system. The latent period between the initiation of medication intake and the appearance of AGEP, as well as a literature search, suggest that furosemide might be the incriminated drug. Conclusion: We have described a rare case of typical AGEP most probably induced by furosemide.
AB - Introduction: Acute generalized exanthematous pustulosis (AGEP) is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. The causative agents are mostly drugs but other triggers have also been described. Case report: A 52 year-old woman with a history of diabetes mellitus type II, dyslipidemia and osteomyelitis was treated for about a year with metformin (Glucophage®) and simvastatin (Simovil®) tablets. Due to the osteomyelitis, the patient was started on a regimen of intravenous vancomycin as well as furosemide tablets (Fusid®) for pedal edema. About seventeen days after beginning treatment with vancomycin and a week after starting furosemide the patient was hospitalized due to an acute pruritic pustular eruption, involving most of her body surface area. Both vancomycin and furosemide treatment were discontinued, and topical treatment was provided. The clinical course was rapid with spontaneous resolution of the pustules followed by a characteristic pin-point post-pustular desquamation. The morphological, clinical and histological findings suggested a definite case of AGEP based on the EuroSCAR scoring system. The latent period between the initiation of medication intake and the appearance of AGEP, as well as a literature search, suggest that furosemide might be the incriminated drug. Conclusion: We have described a rare case of typical AGEP most probably induced by furosemide.
KW - Acute Generalized Exanthematous Pustulosis (AGEP)
KW - Cutaneous adverse drug reactions
KW - Dermatology
KW - Furosemide
KW - Pustular drug eruption
UR - http://www.scopus.com/inward/record.url?scp=33748420393&partnerID=8YFLogxK
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C2 - 16900732
AN - SCOPUS:33748420393
SN - 0017-7768
VL - 145
SP - 477-479+552
JO - Harefuah
JF - Harefuah
IS - 7
ER -