A Rare Case of Acute Generalized Exanthematous Pustulosis with Drug-Induced Liver Injury caused by Pyrazinamide

Abstract Acute Generalized Exanthemataous Pustulosis (AGEP) is a rare acute pustular eruption that is mostly induced by drugs. Aside from cutaneous eruptions, systemic symptoms such as leukocytosis, neutrophilia, and internal organ involvement such as liver, kidney, respiratory system, and bone marrow, may occur, although uncommon. Liver involvement usually results in a two- or three-fold increase of liver enzymes and rarely exceeds that. Pyrazinamide is the first-line anti-tuberculosis drug that is potentially hepatotoxic, but rarely shows dermatologic manifestations. We report a rare case of AGEP with drug induced liver injury due to pyrazinamide in a young patient with tuberculosis.