An unusual presentation of acute generalized exanthematous pustulosis

Introduction: Acute generalized exanthematous pustulosis (AGEP) is a type of cutaneous adverse reaction mostly due to drugs. Typically it presents as sterile pustules over the face or in the major flexures with fever. Herein we report a case of AGEP with unusual clinical presentation.
Case report: A 60 years old lady with diabetes and multiple drug allergies, presented with sudden onset multiple pustules over extensor aspects of upper and lower limbs with lakes of pus, vesicles and bullous lesions.
After establishing the clinical diagnosis of AGEP, patient was started on oral prednisolone to which patient responded well. Histo-pathological features of skin biopsy
are compatible with AGEP.
Discussion: The 3 differential diagnosis which were made accordingly, include AGEP, bullous drug reaction, acute generalized pustular psoriasis. However careful analysis of past medical history and the evolution of skin lesions, aided to make the clinical diagnosis AGEP which was later confirmed by histo-pathology