Cutaneous vasculitis overlap with acute generalised exanthematous pustulosis (AGEP)

Abstract

A man in his 40s developed a severe cutaneous adverse reaction following treatment of septic arthritis with flucloxacillin. The eruption had overlap features of cutaneous vasculitis and acute generalised exanthematous pustulosis which was complicated by renal and liver impairment. This case heightens the variation in presentation of a severe drug eruption.

Figure 1

(A) Purpuric eruption involving distal legs. (B) Extensive papillary dermal red blood cell extravasation and acute neutrophilic fibrinoid vasculitis involving superficial and deep dermal vascular plexus (H&E, original magnification ×20).

Figure 2

(A) Diffuse non-follicular pustular eruption on the trunk and proximal limbs. (B) Intraepidermal pustules and spongiosis of the epidermis with polymorphonuclear inflammatory infiltrates in the dermis (H&E, original magnification ×20).