Acute generalized exanthematous pustulosis

Acute generalized exanthematous pustulosis (AGEP) is a rare form of toxidermia one of the severe cutaneous adverse drug reactions (SCAR). It is a febrile erythematous putular cutaneous reaction most often caused by drugs. It may also be due to a viral infection (enterovirus: coxsackie echovirus or cytomegalovirus) a toxic substance (mercury) or a food allergen. All ages are concerned. The drugs most often responsible are antibiotics such as beta-lactams and pristinamycin. PEAG is a model of delayed drug hypersensitivity mediated by CD8 T lymphocytes. The onset of this toxidermia is short ranging from a few hours to a few days. Diagnosis of this dermatosis is based on clinical and para-clinical criteria. These criteria were validated by a score established in 2001 by the European SCAR study group (EuroSCAR).Clinically PEAG manifests as a bright red sometimes scarlatiniform edematous erythema undertaking the trunk limbs and more particularly the axillary and inguinal folds.