Acute generalized exanthematous pustulosis - 急性汎発性発疹性膿疱症
急性汎発性発疹性膿疱症 (Acute generalized exanthematous pustulosis) (AGEP) はまれな皮膚反応であり、症例の 90% が薬物投与に関連しています。 急性汎発性発疹性膿疱症 (acute generalized exanthematous pustulosis) は、投薬開始から平均 5 日後に突然現れる皮疹が特徴です。これらの発疹は膿疱、つまり、濁ったまたは化膿性の物質（膿）を含む、皮膚の小さな赤白または赤色の発疹です。皮膚病変は通常、原因となる薬剤の使用を中止してから 1 ～ 3 日以内に解消します。
紅斑や膿疱を伴う広範囲の病変が突然出現します。
References
Acute generalized exanthematous pustulosis (AGEP) は、赤い皮膚の基部に小さな膿が詰まった隆起が特徴的な皮膚反応です。これは通常、抗生物質などの特定の薬を服用したときに起こり、すぐに体全体に広がります。原因となる薬剤を中止すると、症状は通常 2 週間以内に消え、多くの場合、皮膚の一部が剥がれ落ちます。通常は重篤ではなく、皮膚に限定されますが、重篤なケースは、 Stevens-Johnson syndrome や toxic epidermal necrolysis などの他の重篤な皮膚反応と一緒に分類される場合があります。治療は主に支持療法であり、病気の完全な解決の予後は通常良好です。
Acute generalized exanthematous pustulosis (AGEP) is an adverse cutaneous reaction characterized by sterile pinpoint nonfollicular pustules atop an erythematous background. Symptoms most often occur in the setting of medication exposure, such as systemic antibiotics, rapidly become generalized, followed by desquamation and resolution within about two weeks of discontinuing the offending trigger. Although mostly self-limited without systemic involvement, severe cases are classified alongside other cutaneous adverse reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms. Treatment is primarily supportive, and the prognosis for complete resolution is excellent.
Acute generalized exanthematous pustulosis (AGEP) is an adverse cutaneous reaction characterized by sterile pinpoint nonfollicular pustules atop an erythematous background. Symptoms most often occur in the setting of medication exposure, such as systemic antibiotics, rapidly become generalized, followed by desquamation and resolution within about two weeks of discontinuing the offending trigger. Although mostly self-limited without systemic involvement, severe cases are classified alongside other cutaneous adverse reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms. Treatment is primarily supportive, and the prognosis for complete resolution is excellent.
Recent experimental data reviewed herein are supportive of an early role of drug-induced innate immune activation and innate cytokines such as interleukin (IL)-1, IL-36, and IL-17 in the pathogenesis of AGEP. This explains the rapid onset and neutrophilic character of the cutaneous inflammation.
76 歳の男性が、過去 2 日間で皮膚の変化を感じたため救急外来を訪れました。医師は彼の胴体と腕と脚に赤い斑点と盛り上がった領域を発見した。時間が経つにつれて、これらの斑点が結合し、赤い部分にニキビのような隆起ができました。検査では、好中球と呼ばれるタイプの白血球数が多く、 C-reactive protein のレベルが増加していることが示されました。
A 76-year-old male patient presented as an emergency due to a 2-day history of skin changes. Physical examination revealed disseminated erythematous macules and plaques on the trunk and extremities. In the further course, confluence of the macules and non-follicular pustulosis developed in the area of erythema. Laboratory tests revealed leukocytosis with neutrophils and elevated C-reactive protein.
A 76-year-old male patient presented as an emergency due to a 2-day history of skin changes. Physical examination revealed disseminated erythematous macules and plaques on the trunk and extremities. In the further course, confluence of the macules and non-follicular pustulosis developed in the area of erythema. Laboratory tests revealed leukocytosis with neutrophils and elevated C-reactive protein.
