Acute generalized exanthematous pustulosis (AGEP) is a rare, usually drug-induced, acute pustular rash. Despite the lack of strong data supporting the effectiveness of topical or systemic corticosteroids in this drug reaction, they are widely used. More generally, there is no consensus on the diagnostic modalities and the management of patients with AGEP. We aimed to provide European expert recommendations for the diagnosis and management or patients with AGEP. Members of the ToxiTEN group of the European Reference Network (ERN)-skin, all dermatologists and/or allergologists with expertise in drug reactions, elaborated these recommendations based on their own experience and on a review of the literature. Recommendations were separated into the following categories: professionals involved, assessment of the diagnosis of AGEP, management of the patient and allergological work-up after the acute phase. Consensus was obtained among experts for the list of professionals involved for the diagnosis and management of AGEP, including the minimum diagnostic work-up, the setting of management, the treatments, the modalities and the timing of allergological work-up and follow-up. European experts in drug allergies propose herein consensus on the diagnosis and management of patients with AGEP. A multidisciplinary approach is warranted, including dermatologists, allergologists and pharmacovigilance services.

Birmingham Children's Hospital Birmingham Women's and Children's NHS Foundation Trust Birmingham UK

Center of Rare Diseases IDI IRCCS Rome Rome Italy

Christine Kühne Center for Allergy Research and Education Davos Davos Switzerland

Department of Dermatology 2 Colentina Clinical Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Dermatology and Allergology Charles Nicolle University Hospital Rouen France

Department of Dermatology and Allergology Tenon Hospital Sorbonne Université INSERM Institut Pierre Louis d'Epidemiologie et de Sante Publique AP HP Sorbonne Universite Paris France

Department of Dermatology and Allergology University Hospital Salzburg of the Paracelsus Medical University Salzburg Salzburg Austria

Department of Dermatology and Allergy Center Odense University Hospital University of Southern Denmark Odense Denmark

Department of Dermatology and Allergy University Hospital Ludwig Maximilian University Munich Munich Germany

Department of Dermatology AP HP Henri Mondor University Hospital Créteil France

Department of Dermatology Center for Blistering Diseases University Medical Center Groningen University of Groningen Groningen The Netherlands

Department of Dermatology Christian Albrechts University Kiel Kiel Germany

Department of Dermatology Edouard Herriot University Hospital Lyon France

Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary

Department of Dermatology King's College Hospital London UK

Department of Dermatology Necker Enfants Malades University Hospital Paris France

Department of Dermatology University Hospital of Bordeaux Bordeaux France

Department of Dermatology University Hospital of Zurich Zurich Switzerland

Department of Dermatology University Hospitals Birmingham Birmingham UK

Department of Dermatology University Medical Center Schleswig Holstein Lübeck Germany

Department of Dermatovenereology Faculty of Medicine St Ann's University Hospital Masaryk University Brno Czech Republic

Department of Paediatric Dermatology Colentina University Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Skin and Venereal Diseases Lithuanian University of Health Sciences Hospital of LUHS Kauno Klinikos Kaunas Lithuania

Dr Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami Florida USA

Faculty of Medicine University of Zurich Zurich Switzerland

Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany

Regional Pharmacovigilance Centre Pitié Salpêtrière Hospital APHP Sorbonne Université Paris France

Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL Reference Center AP HP Henri Mondor Hospital Créteil France

ToxiTEN Group European Reference Network for Rare Skin Diseases Paris France

Univ Paris Est Créteil EpiDermE Créteil France

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