Clinical features of acute generalized exanthematous pustulosis caused by hydroxychloroquine in rheumatology patients and exploration of CARD14 gene mutations

• DOI: 10.3389/fmed.2023.1161837
• Publication Date: 2023-04-06T05:44:58Z
• Authors: Feng Luo; Xue-mei Yuan; Hong Xiong; Yu-zheng Yang; Chang-ming Chen; Wu-kai Ma; Xue-ming Yao
• Keywords: Hydroxychloroquine; Discontinuation; Toxic Epidermal Necrolysis

Introduction Acute generalized exanthematous pustulosis (AGEP) is a rare condition characterized by superficial pustules following drug ingestion or infection. Currently, there no clear link between rheumatism and AGEP. It has been described that hydroxychloroquine (HCQ) cause of acute epidermal necrolysis (AGEP). Presently, are limited studies on HCQ-induced We aimed to explore the clinical features associated gene expression AGEP induced after HCQ treatment exposure in rheumatology patients. Methods assessed patients with diagnosed at Second Affiliated Hospital Guizhou University Chinese Medicine January 1, 2017, May 2022. also reviewed similar cases reported specific databases. Results The study included five females (mean age, 40.2 years), mean time from initiation symptom onset was 12.2 d. All received steroids allergy medications discontinuation, rash completely resolved within an average 25.2 performed whole exome sequencing Sanger validation our patient sample. CARD14 mutations were detected three Additionally, seven mutation sites detected. Discussion may have longer latency period regression than other drugs. Our all experienced mutations. often resolves topical therapy although some require systemic steroid therapy. In future, should pay attention effectiveness during be aware skin toxicity.