Korean J Med.  2011 Dec;81(6):802-806.

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

• Shim IK
• Choi YJ
• Lee SJ
• Lee HW
• Choi GS
• Kim HK
• Suh KS

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.

Keyword

Acute generalized exanthematous pustulosis; Lacquer chicken

MeSH Terms

Acute Generalized Exanthematous Pustulosis
Adult
Anti-Bacterial Agents
Chickens
Dermatitis, Contact
Eating
Edema
Eosinophils
Fever
Humans
Hypersensitivity
Hypotension
Lacquer
Leukocytosis
Male
Neutrophils
Rare Diseases
Recurrence
Shock, Septic
Steroids
Anti-Bacterial Agents
Steroids