Clozapine-Induced Acute Generalized Exanthematous Pustulosis: A Case Report

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Background: Background: Clozapine is one of the most effective treatments for resistant schizophrenia; however, it can cause severe hematological and, rarely, dermatological reactions. Case Presentation: We describe a 25-year-old woman with treatment-resistant schizophrenia who developed acute generalized exanthematous pustulosis (AGEP) four days after clozapine initiation. The rash appeared as widespread erythematous pustules over the face, trunk, and limbs, confirmed clinically as AGEP. Clozapine was discontinued, and she was treated with oral antihistamines and topical calamine, leading to full recovery within two weeks. Discussion: Clozapine-induced AGEP is exceedingly rare, with few cases reported in the literature. The reaction is thought to result from a type IV hypersensitivity mechanism. Prompt recognition, drug withdrawal, and multidisciplinary care are crucial for favorable outcomes. Conclusion: This case underscores the importance of dermatological monitoring in patients receiving clozapine. Early identification and intervention can prevent complications and optimize treatment continuity. Keywords: Acute Generalized Exanthematous Pustulosis, Adverse drug reaction, Clozapine, Schizophrenia, Skin eruption.

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