Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (709 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Rare skin eruption characterized by acute formation of pustules filled with neutrophils, fever, and peripheral blood leukocytosis. Most cases are associated with the use of antibiotics (e.g., beta-lactams).
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Pustulosis, Exanthematous, Acute Generalized; Acute Generalised Exanthematous Pustulosis; Acute Localized Exanthematous Pustulosis; Pustulosis, Exanthematous, Acute Localized.
Where it fits in the MeSH classification
- Broader topics
- Drug Eruptions; Hypersensitivity, Delayed
Related concepts
- Neutrophils
- Leukocytosis
- Beta-Lactams
Research landscape
PubMed indexes 557 records tagged with the MeSH heading “Acute Generalized Exanthematous Pustulosis” (counts retrieved 2026-10-29). 224 of them (40.2%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 330 records.
Reviews account for 76 records (13.6%) and meta-analyses for 1. Randomized controlled trials number 0 (0.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 0 |
| 2000-2009 | 12 |
| 2010-2019 | 330 |
| 2020 onward | 224 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 76 | 13.6% |
| Meta-analyses | 1 | 0.2% |
| Randomized controlled trials | 0 | 0.0% |
Method: PubMed query "Acute Generalized Exanthematous Pustulosis"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in immunology
Immune responses are studied in model organisms, in cells from donors and in patients, and the same pathway can behave differently across these settings. Mouse immune systems differ from human ones in important ways, and blood measurements may not reflect what happens in tissues. Clinical conclusions about immune-mediated disease or immunotherapy come mainly from controlled trials and long-term cohorts. Check the species and tissue studied, whether markers were linked to outcomes patients notice, and the follow-up time.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy | 2016 | Review article Design not recorded in structured metadata | 129 | cc by PMID 27472323 · DOI · PMC5000612 |
| Treatments for Severe Cutaneous Adverse Reactions | 2017 | Review article Design not recorded in structured metadata | 39 | cc by PMID 29445753 · DOI · PMC5763067 |
| In Vitro Assays in Severe Cutaneous Adverse Drug Reactions: Are They Still Research Tools or Diagnostic Tests Already? | 2017 | Research article Design not recorded in structured metadata | 36 | cc by PMID 28796198 · DOI · PMC5578127 |
| Rare acute generalized exanthematous pustulosis caused by iodixanol: A case report | 2025 | Research article Design not recorded in structured metadata | 2 | cc by PMID 39889169 · DOI · PMC11789881 |
Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Acute generalized exanthematous pustulosis (AGEP) is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base and spontaneous resolution usually within two weeks.
- Closing excerpt
- Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (149 words)
Acute generalized exanthematous pustulosis (AGEP) is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base and spontaneous resolution usually within two weeks. Systemic involvement occurs in about 20% of cases. The course is mostly benign, and only in rare cases complications lead to life-threatening situations. Recent studies highlight the importance of genetic variations in interleukin-36 receptor antagonist gene (IL-36RN) in the pathogenesis of this disease. The physiopathology of AGEP remains unclear, but an involvement of innate and acquired immune cells together with resident cells (keratinocytes), which recruit and activate neutrophils via production of cytokines/chemokines such as IL-17, IL-36, granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNFα) and chemokine (C-X-C motif) ligand 8 (CXCL8)/IL-8, has been postulated. Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27472323 · DOI · PMC5000612
Treatments for Severe Cutaneous Adverse Reactions [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Severe cutaneous adverse reaction (SCAR) is life-threatening.
- Closing excerpt
- It may serve as a guidance based on the current best of knowledge and may shed light on the directions for further investigations.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (136 words)
Severe cutaneous adverse reaction (SCAR) is life-threatening. It consists of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), and generalized bullous fixed drug eruptions (GBFDE). In the past years, emerging studies have provided better understandings regarding the pathogenesis of these diseases. These diseases have unique presentations and distinct pathomechanisms. Therefore, theoretically, the options of treatments might be different among various SCARs. However, due to the rarity of these diseases, sufficient evidence is still lacking to support the best choice of treatment for patients with SCAR. Herein, we will provide a concise review with an emphasis on the characteristics and treatments of each SCAR. It may serve as a guidance based on the current best of knowledge and may shed light on the directions for further investigations.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29445753 · DOI · PMC5763067
In Vitro Assays in Severe Cutaneous Adverse Drug Reactions: Are They Still Research Tools or Diagnostic Tests Already? [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Severe cutaneous adverse drug reactions (SCARs) represent life-threatening medical conditions and an appropriate causative diagnosis of these conditions is of the highest importance.
- Closing excerpt
- Some technical issues, limitations, and modifications of routine laboratory methods are also discussed.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (164 words)
Severe cutaneous adverse drug reactions (SCARs) represent life-threatening medical conditions and an appropriate causative diagnosis of these conditions is of the highest importance. Existing in vivo diagnostic methods are risky or are just contraindicated in these patients. Therefore, in vitro tests take on greater significance. In this survey, the studies on in vitro assays in SCARs were identified with a defined searching strategy and strict eligibility criteria. Different methods in the particular clinical manifestations and the groups of drugs were compared in respect to the diagnostic parameters obtained. The lymphocyte transformation test and IFNg-ELISpot (Interferon γ-Enzyme-linked immunospot assay) appeared to have the best evidence currently available. Further diagnostic assays, which are based mostly on distinct mechanisms of SCARs, may outdo previous assays but they still need confirmation in a larger group of patients and in more research centers. Data from pediatric populations and acute generalized exanthematous pustulosis (AGEP) patients are scarce. Some technical issues, limitations, and modifications of routine laboratory methods are also discussed.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 28796198 · DOI · PMC5578127
Rare acute generalized exanthematous pustulosis caused by iodixanol: A case report [4]
Abstract reading summary — source excerpts
- Opening excerpt
- RationaleAcute generalized exanthematous pustulosis (AGEP) is a rare delayed allergic reaction, which is mostly caused by drugs, but there are few reports of iodixanol in particular.
- Closing excerpt
- In the future, with the in-depth exploration of more studies, the use of Iodine Contrast Media will be more standardized and scientific.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (260 words)
RationaleAcute generalized exanthematous pustulosis (AGEP) is a rare delayed allergic reaction, which is mostly caused by drugs, but there are few reports of iodixanol in particular. At present, 4 cases induced by iodixanol have been reported in the literature, but none have been reported in China.Patient concernsIn this report, we report a case of AGEP induced by intravenous bolus infusion of iodixanol during multislice spiral CT enhanced scanning of the whole abdomen in a patient with rectal malignancy. A 35-year-old female patient presented with a larger rash/erythema on the head and neck and felt itchy.DiagnosesA large erythema/rash and white, sterile pustules based on erythema spread from head, neck to the whole body in a short period of time. Blood cell results showed high levels of white blood cell, neutrophils, C-reactive protein and interleukin-10, and decreased levels of some immune indicators. Pathological biopsy results showed that there was immune cell infiltration around the superficial dermis.InterventionsImmediate avoidance of potential allergens and treatment with steroids, antihistamines and other medications, followed by adjustment with cyclosporine and human immunoglobulin.OutcomesAt 1 year's follow-up, the patient did not develop any symptoms of discomfort and increased awareness of allergen prevention.LessonsThe reported case is an extremely rare and severe AGEP, typically characterized by pruritus, edema, large erythema/rash, dense white needle-like sterile pustules based on erythema/rash, and desquamation. After discontinuation of exposure to iodixanol, the patient received symptomatic supportive treatment, mainly drug response. She eventually recovered without recurrence. In the future, with the in-depth exploration of more studies, the use of Iodine Contrast Media will be more standardized and scientific.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39889169 · DOI · PMC11789881
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Severe cutaneous adverse reactions to drugs [5]
- Research article Acute generalized exanthematous pustulosis (AGEP): A review and update [6]
- Research article Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts [7]
- Research article Acute Generalized Exanthematous Pustulosis: Clinical Features, Differential Diagnosis, and Management [8]
- Research article Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine [9]
- Research article Skin tests in the work-up of cutaneous adverse drug reactions: A review and update [10]
References
- Feldmeyer L, Heidemeyer K, Yawalkar N. Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy. . 2016. PMID 27472323 · DOI · PMC5000612
- Cho YT, Chu CY. Treatments for Severe Cutaneous Adverse Reactions. . 2017. PMID 29445753 · DOI · PMC5763067
- Porebski G. In Vitro Assays in Severe Cutaneous Adverse Drug Reactions: Are They Still Research Tools or Diagnostic Tests Already?. . 2017. PMID 28796198 · DOI · PMC5578127
- Ma X, He C, Zeng X, He X, Bi Y. Rare acute generalized exanthematous pustulosis caused by iodixanol: A case report. . 2025. PMID 39889169 · DOI · PMC11789881
- Duong TA, Valeyrie-Allanore L, Wolkenstein P, Chosidow O. Severe cutaneous adverse reactions to drugs. Lancet. 2017. PMID 28476287 · DOI
- Szatkowski J, Schwartz RA. Acute generalized exanthematous pustulosis (AGEP): A review and update. J Am Acad Dermatol. 2015. PMID 26354880 · DOI
- Speeckaert MM, Speeckaert R, Lambert J, Brochez L. Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts. Eur J Dermatol. 2010. PMID 20542841 · DOI
- Parisi R, Shah H, Navarini AA, Muehleisen B, Ziv M, Shear NH, et al.. Acute Generalized Exanthematous Pustulosis: Clinical Features, Differential Diagnosis, and Management. Am J Clin Dermatol. 2023. PMID 37156992 · DOI · PMC10166469
- Schwartz RA, Janniger CK. Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine. Dermatol Ther. 2020. PMID 32253799 · DOI · PMC7235477
- Barbaud A, Castagna J, Soria A. Skin tests in the work-up of cutaneous adverse drug reactions: A review and update. Contact Dermatitis. 2022. PMID 35122269 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
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