Clinical Manifestations and Characteristics of Patients with Acute Generalized Exanthematous Pustulosis in Asia

Acute generalized exanthematous pustulosis is a rare, sterile inflammation of the skin (and mucous membranes) characterized by acute onset of generalized pustule formation, fever and leukocytosis, and a rapid resolution. A computer-based search of the literature revealed only a limited series of reports, none of them based on Asian patients. We identified and retrospectively analysed 16 biopsy-proven and criteria-matched patients over a 15year period in a single medical centre. The study showed a female predominance (11 of 16 patients), a relatively low association with systemic drugs (62.5% vs. 87% in a previous report) and normal renal function (in contrast to a previous report where 32% of patients had renal failure). The study also revealed high levels of C-reactive protein (76.0 mg/l) and normal absolute eosinophil count (176.2/μl) in most patients. Furthermore, there was no difference between different treatment regimens regarding the course and duration of the disease or the length of fever (p > 0.05). In addition, if the patients were subdivided by aetiology into those strongly associated with or not strongly associated with systemic drugs, a significant difference was found in age of onset between the 2 groups (p < 0.01). Key words: acute generalized exanthematous pustulosis; Asians; drug reaction.