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Table 3 AGEP and TEN overlap cases—literature review

From: Acute generalized exanthematous pustulosis simulating toxic epidermal necrolysis: case presentation and literature review

SourcePatientCulprit drugClinical descriptionTime onsetBiopsyTreatmentOutcome
Cohen et al. [16]M 91Cefuroxime
Paracetamol
Generalized erythema (95%), non follicular pustules, bullae (clear)
Skin detachment (41%)
Nikolsky+
10 days after drug initiationSpongiform pustules, papillary edema, perivascular mononuclear infiltrated/c drug
Wet dressing
Resolution after 10 days
Scheinfeld et al. [17]F 60FamotidineGeneralized erythema, pustules
Erosions
Nikolsky+
2 days after drug initiationSubcorneal blistering, no necrotic keratinocytesd/c drug
Clobetasol propionate
Resolution after 3 days
Byerly et al. [18]F 45ValdecoxibGeneralized erythema, nonfollicular
Pustular papules and plaques; 80% BSA
Nikolsky−
5 days after drug initiationSpongiform pustules, neutrophilic and eosinophilic infiltrated/c drug
Wet dressing (bacitracin)
IV fluids
n/a
Meiss et al. [5]M 34
M 49
M 43
Ampilicillin, sulfabactam
Clindamycin
Amoxicillin
Edematous erythema
Oinhead-sized pustules, bullae formation + exfoliation
Nikolsky+
n/aM 49-keratinocytes necrosis of basal layer, neutrophils with subcorneal pustule formationd/c drug
Infliximab
Resolution after 6-14 days
Goh et al. 2008 [4]F 28CarbamazepineGeneralized erythema Non-follicular pustules + clear bullae; 55% BSA, Mq membrane
Nikolsky+
14 days after drug initiationMild spongiosis, subcorneal pustule, necrosis of the epidermisd/c drug
IV Hydrocortisone
IV Ig
Resolution after 9 days
Minimal scarring
Lateef et al. [19]F 67—SLEHydroxy-chloroquineGeneralized erythema
Entire BSA, targetoid patches
Conjunctivitis
Extensive desquamation
19 days after drug initiationEpidermal spongiosis, intradermal infiltrate of neutrophilsd/c drug, IV fluids
IV Hydrocortisone
IV Ig
Resolution after 16 days
Minimal scarring
Sadighha et al. [15]F 56Amoxicillin/clavulanic acidPustules, vesicles, blisters, erythema multiforme-like lesions
Oral + conjunctival inflammation
3 days after drug initiationKeratinocyte necrosis of the basal layerd/c drug
IV fluids
Etanercept s/c
Resolution after 18 days
Peermohamed et al. [20]M 20Piperacillin and
tazobactam
Diffuse erythema, nonfollicular pustules vesicles and bullae
Nikolsky+
1 days after drug initiationIntraepidermal pustules, bulla formation, no necrosisd/c drug
IV Hydrocortisone
IV Ig
Resolution after 14 days
No scarring
Kardaun et al. [21]F 70MorphineGeneralized erythematous eruption
Flexure
Tiny pustules
Superficial erosions
8 days after drug initiationSpongiform subcorneal pustules, neutrophilic spongiose, few necrotic keratinocytesd/c drugResolution after 14 days
Natkunarajah et al. [14]F 19FlucloxacillinPin-head pustules on confluent erythema
Vesicles, bullae
Nikolsky+
5 days after drug initiationSubcorneal pustuled/c drug
Ciclosporin PO
Resolution after 7 days
Hattem et al. [22]F 30FlucloxacillinGeneralized erythema, pustules
Large bullae + erosions
Nikolsky+
5 days after drug initiationSpongiform subcorneal pustules + neutrophils, dermal edemad/c drug
IV fluids
IV Hydrocortisone
Resolution after 10 days
Moling et al. [23]M 29Amoxicillin/clavulanic acidSevere mucositis and pustules
Nikolsky+ 
5 days after drug initiationn/ad/c drug
IV methyl- prednisolone
Hopital discharge after 5 days
Kiyohara et al. [24]M 37LamotrigineVesicles, pustules, bullae on erythematous base
Nikolsky+
14 days after drug initiationSubcorneal pustules, interface dermatitisd/c drug
Prednisolone PO
Resolution after 10 days
Smith et al. [11]F 36FlucloxacillinGeneralized erythema (90%), pustules, bullae
Nikolsky+
n/aMultiple subcorneal pustules, epidermal necrosisd/c drugn/a
Full recovery
Worsnop et al. [25]F 23FlucloxacillinGeneralized erythema, painful blisters
Nikolsky+
14 days after drug coursePapillary dermal edema, subepidermal bullae, subcorneal pustuled/c drug
IV Ig
IV methyl-prednisolone
n/a
Skin healed
Horcajada-Reales et al. [26]F 87Amlodipine or FurosemideErythematous plaques—violaceous center, detachment, perilabial
Nikolsky+
7 days after drug initiationSubcorneal plaques, perivascular dermal infiltrated/c drug
IV Ig
IV corticosteroids
Resolution after 14 days
Horcajada-Reales et al. [26]F 75Teicoplanin
Amlodipine
Papulopustular exanthema trunk + limbs
Epidermal detachment (30%), labial mucosa
Nikolsky+
1 days after drug initiationPustules, spongiose, dense superficial perivascular inflammatory infiltrated/c drug
IV corticosteroids
Resolution after 3 days
García Abellán et al. [27]F 82Trimethoprim
Sulfamethoxazole
Violaceous exanthema
Skin detachment
Nikolsky+
14 days after drug initiationSubcorneal pustules, neutrophilsd/c drug
Prednisone PO
IV Ig
Resolution after 8 days
Moreno-Arrones et al. [3]F 90VismodegibGeneralized erythema Plaques with purpuric centers—head, folds, and trunk
Skin detachment 15%
Nikolsky +
8 days after drug initiationNeutrophilic spongiotic pustules without epidermal necrosisd/c drug,
Ciclosporin
Resolution after 14 days
  1. M male, F female, d days, d/c discontinuation, n/a not available, IV intravenous, s/c subcutaneous, PO by mouth, Ig immunoglobulins