Pathology of acute generalized exanthematous pustulosis

Introduction

Acute Generalized Exanthematous Pustulosis (AGEP) is a rare skin disease which is presented as multiple pustules in a generalized erythematous eruption. Numerous causal drugs and infections have been implicated.

Histology by AGEP

In AGEP, there are spongiosis and minimum acanthosis of the epidermis. Neutrophils spongy Pustules are the most striking feature (figure 1, 2). These pustules are present within the stratum corneum and / or the epidermis. Sometimes, apoptotic keratinocytes are seen in the adjacent epidermis. There is often a dermal answer that is rich in lymphocytes and eosinophils (figure 3).

Special studies for AGEP

None are generally needed. Pustulation may prompt examination of a PAS stain to rule out a fungus etiology

Differential diagnosis by AGEP

Pustular psoriasis: psoriasis generally shows a more impressive postulation, minimal spongiosis, and generally lacks dermis eosinophilia.

Subcorneal Pustular dermatosis: pustules rest on the epidermis and do not form. epidermal pustules Spongiosis is generally not open. There may be clinical and pathological overlap in some cases.

Pemphigus IgA - The intraepidermal The IgA form of pemphigus can closely resemble AGEP. Immunofluorescence it can be useful to distinguish these entities.

Bullous impetigo: Gram's spots should show some subcorneal bacteria. Neutrophilic epidermal postulation is generally not a feature.

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