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- The dermatology department was consulted, and the patient underwent punch biopsy of skin from his left axilla. This revealed intraepidermal pustule formation along with dermal interstitial and perivascular lymphocytic infiltrates and multiple eosinophils, which, given his overall presentation, was a finding thought to be most consistent with acute generalized exanthematous pustulosis triggered by cephalosporin exposure.
- At least 90% of cases of acute generalized exanthematous pustulosis are attributed to medication exposure, with antibiotics, antiepileptic agents, and antihypertensive agents commonly cited as culprits.
- Early skin biopsy was central to making the diagnosis and guiding management.