{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:20:42Z","timestamp":1769577642607,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute Generalized Exanthematous Pustulosis (AGEP)is a rare, severe skin reactionmainly caused by medications such as antibiotics, anti fungals, Calcium channel blockers and Anti malarias. Although it resolves spontaneously in most patients, systemic corticosteroids are neededin severe cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>In order to determine the drug that is causing this condition, patch testing must be performed. Hydroxychloroquine is a medication that is used for the treatment of rheumatic and dermatologic conditions. And although it has been rarely seen to cause this reaction, we report a case of Hydroxychloroquine\u2010induced (HCQ) AGEP which was confirmed by Patch testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A woman 49 years of age with an18 month history of mild, untreated Rheumatoid Arthritis experienced an acute episode of arthritis in her right elbow. Upon going to a rheumatologist, Prednisolone 5\u00a0mg BID and HCQ 200\u00a0mg daily were administered for a 30\u2010day period. But after only 17 days of this treatment, the patient developed generalized erythema and painful pustular eruptions. Prednisolone dosage was changedto 7.5 mg per day andHCQ was discontinued one day afterthe appearance of eruptions. The diffuse erythema started improving a week after the patient\u2019s hospitalization.Considering the factthat our patient was receiving multiple potentially causative medications, patch testing was necessary to distinguish the drug responsible for this reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the patch testing was done, HCQ\u2010induced AGEP was confirmed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patch testing is the gold standard of determining the responsible drug for an AGEP reaction. It should also be kept in mind that HCQ, although rarely, can cause this condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13841","type":"journal-article","created":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T13:50:47Z","timestamp":1605448247000},"page":"2156-2159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The necessity of patch testing in determining the causative drug of AGEP"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5145-792X","authenticated-orcid":false,"given":"Ramin","family":"Mofarrah","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Islamic Azad University of Medical Sciences Sari Branch Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramina","family":"Mofarrah","sequence":"additional","affiliation":[{"name":"Student Research Committee Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Oshriehye","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Faculty of Medicine Islamic Azad University of Medical Sciences Sari Branch Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sueshianth","family":"Ghobadi Aski","sequence":"additional","affiliation":[{"name":"Student Research Committee Islamic Azad University of Medical Sciences Sari Branch Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazanin","family":"Nazemi","sequence":"additional","affiliation":[{"name":"Student Research Committee Islamic Azad University of Medical Sciences Sari Branch Sari Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peyman","family":"Nooshiravanpoor","sequence":"additional","affiliation":[{"name":"Salamat Pathobiology Laboratory Center Qaemshahr Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0560.2001.028003113.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2010.0932"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000051617"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.04434.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.09705.x"},{"key":"e_1_2_6_7_1","first-page":"461","article-title":"Acute generalized exanthematous pustulosis as a manifestation of carbamazepine hypersensitivity syndrome","volume":"18","author":"Son CH","year":"2008","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08156.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1993.tb00178.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1991.01680080069004"},{"key":"e_1_2_6_11_1","first-page":"23","article-title":"Chloroquine and hydroxychloroquine inhibit multiple sites in metabolic pathways leading to neutrophil superoxide release","volume":"15","author":"Hurst NP","year":"1988","journal-title":"J Rheumatol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32834456bf"},{"key":"e_1_2_6_13_1","volume-title":"Acute Generalized Exanthematous Pustulosis Induced by Hydroxychloroquine: First Case Report in Canada and Review of the Literature","author":"Bailey K"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0560.2001.028003113.x"},{"key":"e_1_2_6_15_1","first-page":"S38","article-title":"HLA et predisposition g\u00e9n\u00e9tique dans les pustuloses exanth\u00e9matiques (PEAG) et les exanth\u00e9mes maculo\u2010papuleux (EMP)","volume":"122","author":"Bernard P","year":"1995","journal-title":"Ann Dermatol Venerol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI12118"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1995.tb00553.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.05.014"},{"key":"e_1_2_6_19_1","volume-title":"Plaquenil (hydroxychloroquine sulphate) tablets. 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