A Case of Acute Generalized Exanthematous Pustulosis with Patterns of Septic Shock

옻닭 섭취 후 패혈증 쇼크 양상을 보인 급성 전신성 발진성 농포증 1예

  • Shim, In-Kyoung (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Choi, Youn-Jung (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Lee, Shin-Jun (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Lee, Hae-Won (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Choi, Gil-Soon (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Kim, Hee-Kyoo (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Suh, Kee-Suck (Department of Dermatology, Kosin University College of Medicine)
  • 심인경 (고신대학교 의과대학 내과학교실) ;
  • 최윤정 (고신대학교 의과대학 내과학교실) ;
  • 이신준 (고신대학교 의과대학 내과학교실) ;
  • 이혜원 (고신대학교 의과대학 내과학교실) ;
  • 최길순 (고신대학교 의과대학 내과학교실) ;
  • 김희규 (고신대학교 의과대학 내과학교실) ;
  • 서기석 (고신대학교 의과대학 피부과학교실)
  • Published : 2011.12.01

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a rare disease characterized by multiple acute, small, non-follicular, sterile pustules on an erythematous background, usually accompanied by fever and leukocytosis. AGEP is attributed to systemic drugs, mainly ${\beta}-lactam$ and macrolide antimicrobials, in more than 90% of cases. Systemic contact dermatitis is not rare after ingesting lacquer broth, but few reported cases of AGEP have occurred after the ingestion of lacquer chicken broth without a past history of drugs, viral infection, or contact allergy to mercury. Here, we report a rare case of AGEP with a pattern of septic shock induced by the intake of lacquer chicken in a 40-year-old male patient. He developed a generalized pustular lesion with high fever and hypotension. Histologic examination showed subcorneal neutrophilic pustules, papillary dermal edema, and lymphohistiocytic perivascular infiltrates with some eosinophils and neutrophils. The patient was treated with empirical antibiotics and systemic steroids, and the pustular lesions improved 2 weeks later without recurrence.

급성 전신성 발진성 농포증은 주로 약물에 의해서 유발되며 전신에 융합하는 양상의 홍반성 반과 작은 표재성 농포가 발생하고 흔히 발열과 호중구 증가증을 동반하며 급성으로 진행하지만, 원인 물질을 중단하면 대개 15일 이내에 병변이 호전되는 드문 질환이다. 옻에 의해 발생한 패혈성 쇼크 양상을 보인 급성 전신성 발진성 농포증 1예를 경험하고 드문 증례라 생각하며 문헌고찰과 함께 보고한다.

Keywords

References

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