Acute Generalized Exanthematous Pustulosis

A 60-year-old woman with a history of Sjögren's syndrome, who had begun receiving hydroxychloroquine 25 days previously, presented with generalized erythematous plaques followed by a pruritic, pustular eruption. The patient was febrile, with a temperature of 38.5°C. A 60-year-old woman with a history of Sjögren's syndrome, who had begun receiving 200 mg of hydroxychloroquine daily 25 days previously, presented with a 4-day history of generalized erythematous plaques followed by a pruritic, pustular eruption. The patient was febrile, with a temperature of 38.5°C, but hemodynamically stable. Laboratory examination showed a normal white-cell count (9.2×10 9 per liter) with eosinophilia (eosinophils, 8.8%). The patient said that she had not used any other prescription or over-the-counter medication before the onset of symptoms. Examination revealed widespread edematous erythema covered with numerous discrete, nonfollicular pustules (