What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature
Background Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens. Ob...
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Published in | Mycoses Vol. 65; no. 10; pp. 918 - 925 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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01.10.2022
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Abstract | Background
Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens.
Objectives and Methods
We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS‐CoV vaccine. A detailed review of terbinafine‐induced‐AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine‐induced AGEP case reports. AGEP‐specific Sideroff criteria were analysed in terbinafine‐induced cases and compared to other trigger causes.
Conclusions
When the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination. |
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AbstractList | BackgroundAcute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens.Objectives and MethodsWe describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS‐CoV vaccine. A detailed review of terbinafine‐induced‐AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine‐induced AGEP case reports. AGEP‐specific Sideroff criteria were analysed in terbinafine‐induced cases and compared to other trigger causes.ConclusionsWhen the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination. Background Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens. Objectives and Methods We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS‐CoV vaccine. A detailed review of terbinafine‐induced‐AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine‐induced AGEP case reports. AGEP‐specific Sideroff criteria were analysed in terbinafine‐induced cases and compared to other trigger causes. Conclusions When the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination. Abstract Background Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens. Objectives and Methods We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS‐CoV vaccine. A detailed review of terbinafine‐induced‐AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine‐induced AGEP case reports. AGEP‐specific Sideroff criteria were analysed in terbinafine‐induced cases and compared to other trigger causes. Conclusions When the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination. |
Author | Leão, Felipe Augusto Azevedo Silva, Marcio Roberto Ramos‐e‐Silva, Marcia Sad, Eduardo Fonseca Maia, Maria Luisa Peloso Miotto, Isadora Zago Oliveira, Gisele Viana |
Author_xml | – sequence: 1 givenname: Gisele Viana orcidid: 0000-0001-5101-7097 surname: Oliveira fullname: Oliveira, Gisele Viana email: medderma@gmail.com organization: Luxemburgo Hospital, Instituto Mario Penna – sequence: 2 givenname: Maria Luisa Peloso surname: Maia fullname: Maia, Maria Luisa Peloso organization: Felício Rocho Hospital – sequence: 3 givenname: Felipe Augusto Azevedo surname: Leão fullname: Leão, Felipe Augusto Azevedo organization: Felício Rocho Hospital – sequence: 4 givenname: Eduardo Fonseca surname: Sad fullname: Sad, Eduardo Fonseca organization: Felício Rocho Hospital – sequence: 5 givenname: Isadora Zago orcidid: 0000-0001-8622-3800 surname: Miotto fullname: Miotto, Isadora Zago organization: Felício Rocho Hospital – sequence: 6 givenname: Marcio Roberto surname: Silva fullname: Silva, Marcio Roberto organization: EMBRAPA, UFJF – sequence: 7 givenname: Marcia surname: Ramos‐e‐Silva fullname: Ramos‐e‐Silva, Marcia organization: University Hospital and School of Medicine, Federal University of Rio de Janeiro |
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Notes | This study review has been conducted at the corresponding author address. The case report patient has been treated at the same address, except during in‐hospital care (Felicio Rocho Hospital, BH, MG, Brazil). No undisclosed authors have contributed to the manuscript. ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Review-3 content type line 23 ObjectType-Feature-5 ObjectType-Article-4 ObjectType-Report-1 |
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Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous... Abstract Background Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on... BackgroundAcute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous... BACKGROUNDAcute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non-follicular pustules on edematous... |
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SubjectTerms | Allergens Case reports Drug development drug‐related side effects and adverse reactions Immunization Literature reviews Mercury neutrophilic dermatosis onychomycosis Pustulosis Terbinafine Vaccination |
Title | What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature |
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