Pustulosis Eksantema Generalisata Akut

Main Article Content

Hari Darmawan
Sarah Diba

Abstract

Pustulosis eksantema generalisata akut (PEGA) adalah salah satu erupsi obat alergi berat ditandai pembentukan pustul steril nonfolikular cepat dengan dasar eritem, umum disebabkan penggunaan obat-obatan terutama antibiotik. Pasien mengalami demam mendadak disertai pustulosis dan leukositosis dalam 48 jam setelah konsumsi obat kemudian resolusi spontan dalam 2 minggu dengan gambaran histopatologik khas. Insiden PEGA menurut EuroSCAR sebesar 1-5 kasus persatu juta individu setiap tahun dan dapat terjadi pada semua umur. Diagnosis ditegakkan berdasar skor EuroSCAR. Prognosis PEGA baik karena bersifat self limiting disease dengan menghentikan penggunaan obat pencetus.  

Article Details

Section
Tinjauan Pustaka
Author Biography

Sarah Diba, Fakultas Kedokteran Universitas Sriwijaya Rumah Sakit Umum Pusat Dr. Moh. Hoesin Palembang

Departemen Dermatologi dan Venereologi

References

Shear NH, Knowles SR. Cutaneous reactions to drugs. In: Goldsmith LA., Katz SI, Gilchrest BA, Paller AS, Leffel DJ, Wolff K, eds. Fitzpatrick’s Dermatology In General Medicine. 8th ed. New York: McGraw-Hill Medical; 2012. p. 449-57.

Widaty S, Soebono H, Nilasari H, Listiawan MY, Siswati AS, Rosita C, et al. Erupsi obat alergik. In: Panduan Praktik Klinis. Jakarta: Perdoski; 2017. p. 217-20.

Walsh S, Lee Hy, Creamer D. Severe Cutaneous Adverse Reactions to Drugs. In: Burns T, Breatnach S, Cox N, Griffiths C, eds. Rook’s Textbook of Dermatology. 9th ed. London: Willey-Blackwell Ltd; 2016. p. 119 (1-23).

Revuz J, Allanore LV, Obeid G. Drug reactions. In: Bolognia JL, Jorizzo JL, Rapini RP, eds. 4th ed. New York: Elsevier Saunders; 2012. p. 348-59.

Grekin RC, Neuhaus Im, Wei ML. Contact dermatitis and drug reactions. In: James WD, Berger TG, Elston DM, eds. Andrew’s disease of the skin clinical dermatology. 12th ed. Toronto: Saunders Elsevier; 2015. p. 106-52.

Sidoroff A, Halevy S, Bavinck JN, Vaillant L, Roujeau JC. Acute generalized exanthematous pustulosis (AGEP) clinical reaction pattern. J Cutan Phatol. 2001; 28: 113-9.

Sidoroff A, Dunant A, Viboud C, Halevy S, Naldi L, Mockenhaupt M, et al. Risk factors for acute generalized exanthematous pustulosis (AGEP)-result of a multinational case-control study (EuroSCAR). Br J Dermatol. 2007; 157: 989-96.

Konyoung P, Tassaneeyakul W. Incidence of drug induced-acute generalized exanthematous pustulosis (AGEP) reported in Udonthani Hospital. Sri Nag Med J. 2014; 29(3): 283-7

Girardi M, Duncan KO, Tigelaar RE, Imaeda S, Watsky KL, McNiff JM. Cross-comparison of patch test and lymphocyte proliferation responses in patients with a history of acute generalized exanthematous pustulosis. Am J Dermatopathol. 2005; 27: 343-346.

Lazarov A, Livni E, Halevy S. Generalized pustular drug eruptions: confirmation by in vitro tests. Eur J Acad Dermatol Venereol. 1998; 10: 36-41.

Speeckaert MM, Speeckaert R, Lambert J, Brochez L. Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts. Eur J Acad Dermatol Venereol. 2010; 20(3): 1-9.

Szatkowski J, Schwartz R. Acute generalized exanthematous pustulosis (AGEP): A review and update. Am J Acad Dermatol. 2015; 1:1-6.

Calistru AM, Lisboa C, Cunha AP, Bettencourt H, Azevedo F. Acute generalized exanthematous pustulosis to amoxicillin associated with parvovirus B19 reactivation. Cutan Ocul Toxicol. 2012; 31: 258-61.

Haro GV, Sanchez VJ, Ruiz AP, Gutierrez FJ, Linares J, Naranjo SR. Acute generalized exanthematous pustulosis with cytomegalovirus infection. Int J Dermatol. 1996; 35: 735-737.

Manzano S, Guggisberg D, Hammann C, Laubscher B. Acute generalized exanthematous pustulosis: first case associated with a Chlamydia pneumoniae infection. Arch Pediatr. 2006; 13: 1230-2.

Feldmeyer L, Heidemeyer K, Yawalkar N. Acute generalized exanthematous pustulosis: pathogenesis, genetic background, clinical variants and therapy. Int J Mol Sci. 2016; 17: 1214-23.

Sugiura K. The genetic background of generalized pustular psoriasis: IL36RN mutations and CARD14 gain-of-function variants. J Dermatol Sci. 2014; 74: 187-92.

Capon F. IL36RN mutations in generalized pustular psoriasis: just the tip of the iceberg? J Invest Dermatol. 2013; 133: 2503-4.

Hotz C, Valeyrie-Allanore L, Haddad C. Systemic involvement of acute generalized exanthematous pustulosis: a retrospective study on 58 patients. Br J Dermatol. 2013;169: 1223-32.

Treudler R, Grunewald S, Gebhardt C, Simon J-C. Prolonged course of acute generalized exanthematous pustulosis with liver involvement due to sensitization to amoxicillin and paracetamol. Acta Derm Venereol. 2009; 89: 314-5.

Mohyuddin GR, Al Asad M, Scratchko L, Khaleeq G. Acute generalized exanthematous pustulosis with multiple organ dysfunction syndrome. Am J Crit Care. 2013; 22: 270-3.

Leclair MA, Maynard B, St-Pierre C. Acute generalized exanthematous pustulosis with severe organ dysfunction An J Bras Dermatol. 2009; 181: 393-6.

Brandenburg VM, Kurts C, Eitner F, Hamilton-Williams E, Heintz B. Acute reversible renal failure in acute generalized exanthematous pustulosis. Nephrol Dial Transplant. 2002; 17: 1857-8.

Halevy S, Kardaun SH, Davidovici B, Wechsler J, EuroSCAR and RegiSCAR Study Group. The spectrum of histopathological features in acute generalized exanthematous pustulosis: a study of 102 cases. Br J Dermatol. 2010; 163: 1245-52.

Kardaun SH, Kuiper H, Fidler V, Jonkman MF. The histopathological spectrum of acute generalized exanthematous pustulosis (AGEP) and its differentiation from generalized pustular psoriasis. Cutan J Pathol. 2010;37: 1220-9.

Friedmann PS, Andern-Jones M. Patch testing in drug allergy. Curr Opin Clin Immunol. 2008; 18: 119-22.

Chriac AM, Demoly P. Drug provocation tests: up-date and novel approaches. All Ast J Clin Immunol. 2013; 9(12): 1-5.

Jardin M, Cunha T, Diniz T, Valente N. Subcorneal pustular dermatosis in the pediatric age. An J Bras Dermatol. 2018; 93(1): 116-8.

Travers JB, Mousdicas N. Gram-positive infections associated with toxin production. In: Goldsmith LA., Katz SI, Gilchrest BA, Paller AS, Leffel DJ, Wolff K, eds. Fitzpatrick’s Dermatology In General Medicine. 8th ed. New York: McGraw-Hill Medical; 2012. p. 2148-59.

Thienvibul C, Vachiramon V, Chanprapah K. Five year retrospective review of acute generalized exanthematous pustulosis. Dermatol Res J Prac. 2015; 1: 1-8.