4.5 Editorial Material

Acute Generalized Exanthematous Pustulosis in Close Temporal Association with mRNA-1273 Vaccine

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Clinical presentation and management of atypical and recalcitrant acute generalized exanthematous pustulosis

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Summary: Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction characterized by nonfollicular pustules on a red base that develop rapidly after drug exposure. It is caused by cytokines produced by drug-specific T cells that mediate neutrophilic pustule formation. Individuals with IL-36RN mutations may have an increased risk of developing AGEP. The condition typically presents with leukocytosis and fever during the acute pustular phase, followed by a self-limited recovery phase after stopping the offending drug. Severe cases may involve multiple organ systems.

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Acute Generalized Exanthematous Pustulosis (AGEP) in 12 Patients Treated for SARS-CoV-2 Positive Pneumonia

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Summary: This study describes 12 patients with SARS-CoV-2 pneumonia who developed an acute erythematous rash with nonfollicular pinhead-sized pustules. They were treated with systemic corticosteroids and showed improvement after several days. AGEP is classified as a severe cutaneous adverse reaction typically resolving spontaneously in less than 15 days. Recognizing AGEP is crucial to avoid confusion with systemic infections and prevent incorrect treatments.

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A systematic review on treatment-related mucocutaneous reactions in COVID-19 patients

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Summary: Most drugs, including COVID-19 medications, can cause mucocutaneous reactions. The interval between drug usage and the eruption varies depending on the drug type, with hydroxychloroqine having the longest mean interval. Antivirals, antimalarials, azithromycin, and tocilizumab are the most responsive drugs for adverse reactions. Different drugs have different rates of dermatologic adverse effects, potentially leading to life-threatening reactions in rare cases.

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COVID-19 vaccine-induced acute generalized exanthematous pustulosis

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Acute generalized exanthematous pustulosis (AGEP): A review and update

Jesse Szatkowski et al.

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