Acute generalized exanthematous pustulosis (AGEP) is a rare and severe cutaneous adverse reaction, often triggered by medications. It is characterized by the rapid onset of numerous sterile, non-follicular pustules on an erythematous base. This clinical vignette on AGEP aims to guide residents in identifying and managing this challenging condition. Through this case, users will learn about the clinical features of AGEP, its differential diagnosis, and appropriate diagnostic and management strategies.
This vignette is an excellent resource for residents preparing for OSCE-style examinations and can also be used as a self-directed learning tool for healthcare professionals seeking to enhance their knowledge and skills in managing AGEP.
We invite you to explore the associated learning module and quizzes to reinforce your knowledge and test your understanding of this important topic.
Sources
- Litaiem N, Hajlaoui K, Karray M, Slouma M, Zeglaoui F. Acute generalized exanthematous pustulosis after COVID‐19 treatment with hydroxychloroquine. Dermatologic Therapy. 2020 May 13.
- Nili A, Zarei E, Ghamari A, Farid AS, Tavakolpour S, Daneshpazhooh M, Mahmoudi H. Acute generalized exanthematous pustulosis with a focus on hydroxychloroquine: A 10-year experience in a skin hospital. Int Immunopharmacol. 2020 Oct 19;89(Pt B):107093. doi: 10.1016/j.intimp.2020.107093.
- Paradisi A, Bugatti L, Sisto T, Filosa G, Amerio PL, Capizzi R. Acute generalized exanthematous pustulosis induced by hydroxychloroquine: three cases and a review of the literature. Clinical therapeutics. 2008 May 1;30(5):930-40.
- Schwartz RA, Janniger CK. Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine. Dermatologic Therapy. 2020 Apr 6:e13380.
- Szatkowski J, Schwartz RA. Acute generalized exanthematous pustulosis (AGEP): a review and update. Journal of the American Academy of Dermatology. 2015 Nov 1;73(5):843-8.
- Photo courtesy of DermNet NZ. DermnetNZ.org

Release Date: April 18th 2023
Last Updated: April 18th 2023
Time to complete: 30 minutes
Authors:
- Dr. Zeinah Alhalees, MD, University of British Columbia.
- Dr. Mathieu Powell, MD, McGill University.
- Dr. Elena Netchiporouk, MD, McGill University

