급성전신발진농포증 환자의 임상 및 조직학적 분석 (Clinicopathological Analysis of Patients with Acute Generalized Exanthematous Pustulosis)

서지정보

· 발행기관 : 대한피부과학회
· 수록지 정보 : 대한피부과학회지 / 56권 / 10호 / 594 ~ 602페이지
· 저자명 : 정인순, 윤숙정, 이지범, 김성진, 이승철, 원영호

초록

Background: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea.
Objective: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context.
Methods: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients’ medical records and photographs.
Results: The mean age of onset was 43.6 years, and the male：female ratio was 2.1：1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients.
Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group.
Conclusion: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP.

영어초록

Background: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea.
Objective: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context.
Methods: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients’ medical records and photographs.
Results: The mean age of onset was 43.6 years, and the male：female ratio was 2.1：1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients.
Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group.
Conclusion: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP.

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