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AGEP — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesAGEPRACP Adult Medicine

A 50-year-old woman on amoxicillin for 48 hours develops acute onset of widespread non-follicular sterile pustules on an erythematous base, fever (39°C), and neutrophilia (18 × 10⁹/L). The rash resolves within 2 weeks of drug cessation with desquamation. No mucosal involvement. What is the most likely severe drug reaction?

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Correct answer: B — Acute generalised exanthematous pustulosis

Acute onset (<48 hours) of widespread non-follicular sterile pustules on erythematous skin with fever, neutrophilia (not eosinophilia), no mucosal involvement, and rapid resolution after drug cessation is AGEP. Antibiotics (especially aminopenicillins) are the most common cause. It has the best prognosis among SCARs (mortality <5%). Treatment is drug withdrawal and supportive care.

Reference: EuroSCAR AGEP Criteria; eTG Dermatology 2024