A Case of Acute Generalized Exanthematous Pustulosis with Patterns of Septic Shock / 대한내과학회지

ABSTRACT

Acute generalized exanthematous pustulosis (AGEP) is a rare disease characterized by multiple acute, small, non-follicular, sterile pustules on an erythematous background, usually accompanied by fever and leukocytosis. AGEP is attributed to systemic drugs, mainly beta-lactam and macrolide antimicrobials, in more than 90% of cases. Systemic contact dermatitis is not rare after ingesting lacquer broth, but few reported cases of AGEP have occurred after the ingestion of lacquer chicken broth without a past history of drugs, viral infection, or contact allergy to mercury. Here, we report a rare case of AGEP with a pattern of septic shock induced by the intake of lacquer chicken in a 40-year-old male patient. He developed a generalized pustular lesion with high fever and hypotension. Histologic examination showed subcorneal neutrophilic pustules, papillary dermal edema, and lymphohistiocytic perivascular infiltrates with some eosinophils and neutrophils. The patient was treated with empirical antibiotics and systemic steroids, and the pustular lesions improved 2 weeks later without recurrence.