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Image Number #8860 (Acute Localized Exanthematous pustulosis)

Diagnosis: Acute Localized Exanthematous pustulosis

Description:

Localised pustules resolving with a topical steroid cream

Morphology: Pustules

Site: Chin

Sex: F

Age: 23

Type: Clinical

Submitted By: Ian McColl

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Differential Diagnosis
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History:

Patient of Dr 

23 years old girl
She developed pustular rash on the right side of her chin after taking Augmentin Duo for UTI. She reports history of similar skin lesions on the same area few months earlier after taking Amoxicillin.
Rash disappeared few day after applying Hydrocortisone %1 ointment bd and switching Augmentin Duo to Trimethoprim for UTI.
Works as a nurse at hospital, no history of reaction or allergy to other medicines. PMH: mild asthma

I also have never seen a pustular fixed drug reaction . It looks very infected but if cultures are negative and it improves with hydrocortisone and stopping the suspected drug then it may instead be a localised version of AGEP (acute generalised exanthematous pustulosis)
Pyoderma faciale is more chronic and lasts weeks. (Submitted By: Dr Ian McColl)

See this article on Drug rashes

DermNetNZ   eMedicine   PubMed   Dermatology Online   Archives   JAAD for "Acute Localized Exanthematous pustulosis"

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