Subcorneal pustulosis (Sneddon-Wilkinson disease) is a rare inflammatory neutrophilic dermatosis. While subcorneal pustulosis is often associated with an IgA gammopathy, the combined lack of IgG/IgM seen in our case is rare. An 83-year-old man with combined lack of IgG/IgM and monoclonal gammopathy type IgA/Kappa presented with subcorneal pustules. Intravenous immunoglobulin therapy led to complete regression and might be another therapeutic option.
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Acute generalized exanthematous pustulosis is a severe cutaneous adverse reaction characterized by the rapid onset of nonfollicular, sterile pustules on an erythematous base, typically accompanied by fever (≥38 °C), neutrophilia (7.0 × 10⁹/L), and characteristic histopathological features. This case report presents the first documented instance of acute generalized exanthematous pustulosis after hyaluronic acid viscosupplementation.
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Article Synopsis
- Acute generalized exanthematous pustulosis (AGEP) is a serious but rare reaction to clindamycin, characterized by pustular lesions, fever, and itching, primarily seen in females around the median age of 57.
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- The condition is self-limiting, and patients experienced recovery after stopping the drug and receiving supportive care, with a typical recovery time of 9 days; thus, awareness and prompt action by clinicians are crucial.
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