Clindamycin-induced acute generalized exanthematous pustulosis: A case report

Abstract

Rationale:Acute generalized exanthematous pustulosis (AGEP) is a severe pustular cutaneous adverse drug reaction. Sterile, non-follicular pustules overlying the erythematous skin characterize this reaction.Patient concerns:A 30-year-old Asian women presented with sterile, non-follicular lesions with pus-fluid levels on her back 2 days after taking clindamycin. Skin biopsy revealed a spongiotic change in the epidermis with a focal subcorneal pustule and perivascular eosinophil and lymphocyte infiltration.Diagnosis:Clindamycin-induced AGEP.Interventions:We discontinued clindamycin treatment and prescribed systemic corticosteroids.Outcomes:The pustule stopped spreading within 1 day and the rash improved within 2 days.Lessons:AGEP is a pustular cutaneous adverse drug reaction that can appear with pus-fluid levels, clinically mimicking Sneddon-Wilkinson disease. The differentiation between both conditions is a history of drug use, characteristic skin lesions and histopathology.