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Case Reports
. 2019 Feb 11;12(2):e223528.
doi: 10.1136/bcr-2017-223528.

Hydrochlorothizide-induced acute generalised exanthematous pustulosis presenting with bilateral periorbital impetigo

Leo E Reap  1 , Cassandra Rodd  2 , Jose Larios  3 , Michael Marshall  3
Affiliations
Case Reports

Hydrochlorothizide-induced acute generalised exanthematous pustulosis presenting with bilateral periorbital impetigo

Leo E Reap et al. BMJ Case Rep. .

Abstract

Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction characterised by the appearance of erythematous plaques and papules with overlying non-follicular pinpoint pustules. Drugs are the cause of AGEP in approximately 90% of cases. The most common causes include anti-infective agents (aminopenicillins, quinolones, antibacterial sulfonamides and terbinafine), antimalarials and diltiazem. To the best of our knowledge, to date there has only been one report of hydrochlorothiazide-induced AGEP. There has never been a case report of losartan-induced AGEP. Here, we present a case of AGEP that is the second case purportedly caused by hydrochlorothiazide.

Keywords: cardiovascular system; dermatology; drug interactions unwanted effects / adverse reactions; drugs and medicines.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Acute generalised exanthematous pustulosis with periorbital impetigo and facial desquamation.
Figure 2
Figure 2
Confluent patchy erythema, desquamation and pustule formation extending along the dorsum of the arm consistent with acute generalised exanthematous pustulosis.
Figure 3
Figure 3
On 2-week follow-up after discontinuation, demonstrating complete resolution.
Figure 4
Figure 4
Minimal residual desquamation present with healthy new skin developing beneath.
See this image and copyright information in PMC

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References

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