Acute generalized exanthematous pustulosis

Acute generalized exanthematous pustulosis, often called AGEP, is a rare and serious skin reaction that is almost always triggered by medications. It causes a sudden outbreak of many tiny, non-infectious pustules (small blisters filled with pus) on top of widespread red, swollen skin. The reaction typically begins within a few hours to a few days after starting a new medication, most commonly antibiotics like aminopenicillins and macrolides, but also other drugs such as calcium channel blockers, antimalarials, and antifungals. In rare cases, viral infections or spider bites have been reported as triggers. The condition usually starts with a high fever (often above 38°C or 100.4°F) and a burning or itching sensation on the skin, especially in the skin folds and on the face and trunk. Within hours, hundreds of tiny sterile pustules appear on a background of bright red skin. Patients may also experience swelling of the face and hands, and blood tests often show a high white blood cell count. The good news is that AGEP is usually self-limiting, meaning it resolves on its own once the offending drug is stopped. Most people recover fully within one to two weeks. Treatment is mainly supportive, focusing on stopping the triggering medication, managing fever, and caring for the skin with moisturizers or mild topical corticosteroids. Severe cases may require hospitalization, especially in elderly patients or those with other health conditions. While AGEP can look alarming, the overall prognosis is very good, with a mortality rate estimated at less than 5%, mostly in patients who have significant underlying health problems.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Bring these to your next appointment

• Q1.Which specific medication most likely caused my AGEP reaction?,Are there related medications I should also avoid in the future?,Should I undergo patch testing to confirm the triggering drug?,How should I care for my skin during the healing process?,What warning signs should prompt me to seek emergency care?,Should I wear a medical alert bracelet or carry a drug allergy card?,Is there any risk that my family members could have a similar reaction to this medication?

Common questions about Acute generalized exanthematous pustulosis

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