Acute Generalized Exanthematous Pustulosis in a Child without Drug Intake: Clinical and Histological Features

Acute generalized exanthematous Pustulosis (AGEP) is a rare and sometimes life-threatening, cutaneous reaction caused by drugs in more than 90% of cases, with antibiotics the most frequent triggers. It is a potentially fatal skin reaction rarely observed in children and can be atypical in its presentation. Clinically, it is characterized by the acute onset of dozens of sterile,non-follicular, small pustules on edematous erythema, few hours to three weeks after exposure to the causative agent. The lesions begin on the face and/or skin folds, with widespread distribution after. Systemic symptoms are mild and the disease normally resolves spontaneously after the inciting agent is withdrawn. We report a rare case of AGEP in an 8-year-old boy with no history of drug intake. Through our case, we highlight the atypical clinical and histological presentation, with special concern of the therapeutic options especially in children.