Acute generalized exanthemic pustulosis.

Acute generalized exanthemic pustulosis often presents dramatically with the abrupt onset of a widespread pustular eruption on an erythematous base, with a frequently positive Nikolsky sign. In most cases, penicillins or macrolides are causally related. The main differential diagnosis of a generalized pustular eruption in a febrile patient is pustular psoriasis, which can be differentiated on both a clinical and histologic basis.