Azathioprine-induced acute generalized exanthematous pustulosis in a woman with autoimmune hepatitis

Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous drug reaction characterized by sterile pustules on erythematous skin. Azathioprine (AZA)-induced AGEP is rare, with few cases documented. We report a 50-year-old female with autoimmune hepatitis who developed a widespread pustular rash five days following the beginning of AZA therapy. Histopathology confirmed subcorneal pustules accompanied by eosinophilic infiltrates, indicative of AGEP. The discontinuation of AZA and systemic corticosteroids resulted in swift remission. This instance highlights the significance of prompt identification and discontinuation of medication to prevent adverse consequences.