Acute Generalized Exanthematous Pustulosis after Ingestion of Lacquer Chicken: CASE REPORT
A 40-year-old man was admitted to our department with a pruritic rash of four days duration. Six days before, he had ingested lacquer chicken as a health food. Physical examination demonstrated marked generalized, symmetrical erythema with multiple overlying small pustules on the trunk, medial arms, and proximal legs (Fig. 1). The patient also had a fever and complained of severe itching and burning. He had ingested lacquer chicken a couple of times in the past, but this was the first time he had developed a skin eruption. He reported no history of psoriasis, drug ingestion, recent infection, or contact with mercury.
Laboratory studies showed leucocytosis (17-3*109/ L) with neutrophilia and hypocalcaemia (7.9 mg/dl). The ESR and CRP were elevated (23 mm/h and 5.22 mg/dl). A skin biopsy specimen taken from a pustular lesion on the thigh revealed intracorneal pustules with neutrophils. The papillary dermis was edematous, and a superficial perivascular lympho- cytic infiltrate with scattered interstitial neutrophils and eosinophils was noted (Fig. 2). On the basis of clinical, histopathological, and laboratory findings, a diagnosis of AGEP was made. Viagra Professional
Fig. 1. (A) Generalized, symmetrical erythema with overlying pustules on the trunk. (B) Numerous small pustules were more clearly visualized on the posterior thigh.
The patient was treated with systemic cortico- steroids and antihistamines, along with topical corti- costeroids. The pustules rapidly resolved over three days with desquamation, and the generalized erythema completely resolved within ten days.
Fig. 2. A skin biopsy showed an intracorneal pustule with neutrophils and spongiosis. A mixed interstitial and perivascular infiltrate of neutrophils, lymphocytes, and eosinophils was present in the dermis (H&E, x200).
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