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Potential side effect of high-dose corticosteroid relapse treatment: acute generalized exanthematous pustulosis (AGEP)

Department of Neurology, Multiple Sclerosis Center, University Clinic Carl Gustav Carus, University of Technology Dresden, Dresden, Germany Tjalf.Ziemssen{at}uniklinikum-dresden.de

A Bauer

Department of Dermatology, University Clinic Carl Gustav Carus, University of Technology Dresden, Dresden, Germany

M Bär

Department of Dermatology, University Clinic Carl Gustav Carus, University of Technology Dresden, Dresden, Germany

Introduction

High-dose glucocorticosteroids (GC) are the treatment of choice for acute relapses in patients with multiple sclerosis as proven by several controlled clinical trials. The common adverse effects of GC are well known

Case Presentation

In this study, we report on the exceptional case of a young female treated with intravenous high-dose prednisolone for optic neuritis who developed acute generalized exanthematous pustulosis (AGEP). AGEP is a rare cutaneous adverse reaction induced most frequently by antimicrobial or antihypertensive drugs and viral infections. It is characterized by a febrile erythematous and pustular rash and blood granulocytosis.

Conclusion

In our patient, switching to dexamethasone for the next relapse was tolerated well and is an option for treatment. AGEP is a rare adverse effect of carticosteroid treatment.

Key Words: acute generalized exanthematous pustulosis • Multiple sclerosis • steroids

This version was published on February 1, 2009

Multiple Sclerosis, Vol. 15, No. 2, 275-277 (2009)
DOI: 10.1177/1352458508097218


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