Журнал фармаконадзора

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Acute Generalized Exanthematous Pustulosis in a 51-Year-Old Patient under Etanercept Treatment for Psoriasis

Luciana Mabel Ferreira Vasconcelos, Fabricia Martins Teixeira, Eudiana Vale Francelino, Thereza Lucia Prata Almeida, Larissa Bomfim Chagas, Jose Telmo Valença Jr and Aparecida Tiemi Nagao-Dias

Acute generalized exanthematous pustulosis (AGEP) is a cutaneous reaction mostly related to drug, which is characterized by a rapid appearance of fever, erythema, sterile pustules and neutrophilia. We report a 51-year-old female patient who had taken etanercept 50 mg/week for treatment of psoriasis. In the third month of pharmacotherapy, she interrupted the treatment on her own, and consequently, the lesions reappeared. When the drug was reintroduced, it was associated with prednisone 40 mg/day during 5 days. After this period, multiple erythematous and edematous lesions appeared with small non-follicular pustules. Oral corticosteroid was administered and a progressive and complete improvement was achieved. Histopathological findings revealed AGEP. Bacterioscopy of the pustules proved negative. The patient obtained the score 12 according to the EuroSCAR study group, which indicated a definitive diagnosis of AGEP. The criteria for diagnosis were based on morphology, course and histology of the skin reaction. The association between Etanercept and AGEP is an uncommon finding in the literature.