Acute generalized exanthematous pustulosis

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  • Also known as a pustular drug eruption or toxic pustuloderma
  • Typically triggered by medications
    • Antibiotics (especially β-lactams) are most common trigger by far, followed by PPIs, NSAIDs, and herbal medicine
  • Characteristic rash is diffuse, erythematous, with many pinpoint pustules
    • Typically starts in face or intertriginous areas, then spreads centrally
    • Can involve palms and soles but not mucosa
    • May be followed by desquamation
  • Can also have systemic symptoms
  • May have mild liver enzyme abnormalities