Hydroxychloroquine and Acute Generalized Exanthematous Pustolosis

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Justine Galambus
Atefah Vafa


acute generalized exanthematous pustulosis, hydroxychloroquine, drug reactions


Acute generalized exanthematous pustulosis (AGEP) is a rare, potentially lethal, cutaneous reaction most commonly precipitated by drugs. Removal of the offending drug or treatment of the underlying infection usually results in recovery, though corticosteroids are often used to bolster treatment. We report a case of hydroxychloroquine-induced AGEP in an adult female. Though removal of hydroxychloroquine (HCQ) did largely resolve her rash, she continued to require corticosteroids over 200 days after she first began taking HCQ.


1. Sidoroff A, Dunant A, Viboud C, et al. Risk factors for acute generalized exanthematous pustulosis (AGEP)-results of a multinational case-control study (EuroSCAR). Case Control Study. Br J Dermatol. Nov 2007;157(5):989-96. doi:10.1111/j.1365-2133.2007.08156.x

2. Roujeau JC. Clinical heterogeneity of drug hypersensitivity. Review. Toxicology. Apr 15 2005;209(2):123-9. doi:10.1016/j.tox.2004.12.022

3. Hoetzenecker W, Nägeli M, Mehra ET, et al. Adverse cutaneous drug eruptions: current understanding. Review. Semin Immunopathol. Jan 2016;38(1):75-86. doi:10.1007/s00281-015-0540-2

4. Evans CC, Bergstresser PR. Acute generalized exanthematous pustulosis precipitated by hydroxychloroquine. Case Report. J Am Acad Dermatol. Apr 2004;50(4):650-1. doi:10.1016/s0190-9622(03)02733-6

5. Castner NB, Harris JC, Motaparthi K. Cyclosporine for corticosteroid-refractory acute generalized exanthematous pustulosis due to hydroxychloroquine. Case Report. Dermatol Ther. Sep 2018;31(5):e12660. doi:10.1111/dth.12660

6. Matsuda-Hirose H, Sho Y, Yamate T, et al. Acute generalized exanthematous pustulosis induced by hydroxychloroquine successfully treated with etretinate. Case Report. J Dermatol. Feb 2020;47(2):e53-e54. doi:10.1111/1346-8138.15185

7. Schwartz RA, Janniger CK. Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine. Article. Dermatol Ther. May 2020;33(3):e13380. doi:10.1111/dth.13380

8. Szatkowski J, Schwartz RA. Acute generalized exanthematous pustulosis (AGEP): A review and update. Review. J Am Acad Dermatol. Nov 2015;73(5):843-8. doi:10.1016/j.jaad.2015.07.017

9. Pearson KC, Morrell DS, Runge SR, Jolly P. Prolonged pustular eruption from hydroxychloroquine: an unusual case of acute generalized exanthematous pustulosis. Case Report. Cutis. Mar 2016;97(3):212-6.

10. Delaleu J, Deniau B, Battistella M, et al. Acute generalized exanthematous pustulosis induced by hydroxychloroquine prescribed for COVID-19. Case Report. J Allergy Clin Immunol Pract. Jun 7 2020;doi:10.1016/j.jaip.2020.05.046

11. Schrezenmeier E, Dörner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol. Mar 2020;16(3):155-166. doi:10.1038/s41584-020-0372-x

12. Elavarasi A, Prasad M, Seth T, et al. Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis. J Gen Intern Med. Nov 2020;35(11):3308-3314. doi:10.1007/s11606-020-06146-w

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