The safety and interpretability of skin tests with omalizumab.

other laboratory values were unremarkable. A biopsy specimen was not taken. The patient was treated with 0.05% topical desonide lotion for the rash, the antihistamines hydroxyzine and levocetirizine for the pruritus, and empirical antibiotics for possible systemic infection. On day 4, his fever had subsided completely and all blood culture results were negative. On day 6, generalized cutaneous desquamation occurred with marked resolution of his erythema and pustules. AGEP is characterized by a sudden onset of fever and widespread numerous nonfollicular sterile pustules and has a benign, self-limiting course.1 Although most cases of AGEP (!90%) have been associated with drugs, in particular antibiotics, its origin is variable, and it may be triggered by viral infection, hypersensitivity to mercury, or spider bites. Several case reports have described patients with AGEP induced by contrast media, including 2 patients with delayed, generalized, and protracted cutaneous reactions compatible with AGEP after contrast medium administration,4 1 patient with contrast-induced AGEP,5 and 1 patient who developed a pruritic pustular eruption on 2 separate occasions after administration of a nonionic contrast medium.6 The main histopathologic findings in most patients with AGEP include spongiform superficial pustules, papillary edema, polymorphonuclear cells with some perivascular eosinophils, and leukocytoclastic vasculitis with fibrinoid deposits. Our patient had the characteristic morphologic features and course of AGEP, except that histologic features could not be identified because no biopsy specimen was obtained. To our knowledge, this is the first case of AGEP induced by contrast media ever reported in Korea. Physicians should bear in mind that AGEP can be induced by radiocontrast media.