Acute generalised exanthematous pustulosis associated with upadacitinib treatment
Abstract Acute generalised exanthematous pustulosis (AGEP) is a rare drug‐induced pustular eruption characterised by the rapid onset of superficial pinhead pustules. We discuss the case of a 27‐year‐old man who presented with a generalised pustular eruption on the neck, trunk and limbs. He commenced...
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| Format: | Article |
| Language: | English |
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Wiley
2024-12-01
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| Series: | Skin Health and Disease |
| Online Access: | https://doi.org/10.1002/ski2.444 |
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| author | Thandiwe Banda Sanaa Butt Madhavi Maheshwari Moumita Chattopadhyay |
| author_facet | Thandiwe Banda Sanaa Butt Madhavi Maheshwari Moumita Chattopadhyay |
| author_sort | Thandiwe Banda |
| collection | DOAJ |
| description | Abstract Acute generalised exanthematous pustulosis (AGEP) is a rare drug‐induced pustular eruption characterised by the rapid onset of superficial pinhead pustules. We discuss the case of a 27‐year‐old man who presented with a generalised pustular eruption on the neck, trunk and limbs. He commenced upadacitinib for the treatment of atopic dermatitis (AD) 6 months before developing the rash, and the dose was increased from 15 to 30 mg daily, 3 months prior. His only other medication was oral terbinafine, for suspected tinea corporis, which was initiated 1 month before developing the pustular eruption. Laboratory investigations showed a mildly raised CRP 25 mg/L, neutrophilia 8.22 10 × 9/L, and a mildly raised ALT 46 U/L. A skin biopsy showed subcorneal pustules and a few scattered keratinocytes. Upadacitinib and terbinafine were suspended and the pustular eruption resolved. Updacitinib was reintroduced 3 weeks later as the rash was thought to be due to terbinafine and the rash recurred. He was diagnosed with AGEP secondary to upadacitinib. Upadacitinib is a selective JAK inhibitor that is increasingly used for the management of AD and clinicians should be aware that AGEP is a rare but severe adverse effect. |
| format | Article |
| id | doaj-art-28057ece0dda43cb924a8f39f5cc865c |
| institution | Kabale University |
| issn | 2690-442X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Skin Health and Disease |
| spelling | doaj-art-28057ece0dda43cb924a8f39f5cc865c2024-12-02T04:03:51ZengWileySkin Health and Disease2690-442X2024-12-0146n/an/a10.1002/ski2.444Acute generalised exanthematous pustulosis associated with upadacitinib treatmentThandiwe Banda0Sanaa Butt1Madhavi Maheshwari2Moumita Chattopadhyay3Dermatology Department Birmingham City Hospital Sandwell and West Birmingham Hospital Trust Birmingham UKDermatology Department Birmingham City Hospital Sandwell and West Birmingham Hospital Trust Birmingham UKHistopathology Department Royal Wolverhampton NHS Trust Wolverhampton UKDermatology Department Birmingham City Hospital Sandwell and West Birmingham Hospital Trust Birmingham UKAbstract Acute generalised exanthematous pustulosis (AGEP) is a rare drug‐induced pustular eruption characterised by the rapid onset of superficial pinhead pustules. We discuss the case of a 27‐year‐old man who presented with a generalised pustular eruption on the neck, trunk and limbs. He commenced upadacitinib for the treatment of atopic dermatitis (AD) 6 months before developing the rash, and the dose was increased from 15 to 30 mg daily, 3 months prior. His only other medication was oral terbinafine, for suspected tinea corporis, which was initiated 1 month before developing the pustular eruption. Laboratory investigations showed a mildly raised CRP 25 mg/L, neutrophilia 8.22 10 × 9/L, and a mildly raised ALT 46 U/L. A skin biopsy showed subcorneal pustules and a few scattered keratinocytes. Upadacitinib and terbinafine were suspended and the pustular eruption resolved. Updacitinib was reintroduced 3 weeks later as the rash was thought to be due to terbinafine and the rash recurred. He was diagnosed with AGEP secondary to upadacitinib. Upadacitinib is a selective JAK inhibitor that is increasingly used for the management of AD and clinicians should be aware that AGEP is a rare but severe adverse effect.https://doi.org/10.1002/ski2.444 |
| spellingShingle | Thandiwe Banda Sanaa Butt Madhavi Maheshwari Moumita Chattopadhyay Acute generalised exanthematous pustulosis associated with upadacitinib treatment Skin Health and Disease |
| title | Acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| title_full | Acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| title_fullStr | Acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| title_full_unstemmed | Acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| title_short | Acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| title_sort | acute generalised exanthematous pustulosis associated with upadacitinib treatment |
| url | https://doi.org/10.1002/ski2.444 |
| work_keys_str_mv | AT thandiwebanda acutegeneralisedexanthematouspustulosisassociatedwithupadacitinibtreatment AT sanaabutt acutegeneralisedexanthematouspustulosisassociatedwithupadacitinibtreatment AT madhavimaheshwari acutegeneralisedexanthematouspustulosisassociatedwithupadacitinibtreatment AT moumitachattopadhyay acutegeneralisedexanthematouspustulosisassociatedwithupadacitinibtreatment |