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Dermatology
Acute generalised exanthematous pustulosis and herpes simplex virus: a case of possible overlap
  1. Rachel Leigh Zachian1,2,
  2. Bernita V Sidhu1,
  3. Phillip Liu1 and
  4. Rina Weimann3,4
  1. 1Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA
  2. 2Dermatology, University of Maryland, Baltimore, Maryland, USA
  3. 3Main Line Health System, King of Prussia, Pennsylvania, USA
  4. 4Schweiger Dermatology Group, King of Prussia, Pennsylvania, USA
  1. Correspondence to Dr Rachel Leigh Zachian; rzachian{at}gmail.com

Abstract

Acute generalised exanthematous pustulosis (AGEP) is a rare cutaneous disorder that presents with numerous non-follicular, pinpoint sterile pustules on a background of oedematous erythema that can coalesce, leading to desquamation. 90% of cases are triggered by medications, most often with antibiotics as the culprit. However, other triggers including viral infection have also been reported. Herpes simplex virus (HSV) as a viral trigger has not been previously explored. Here, we present a case of AGEP caused by bupropion, followed by a second presentation of assumed acute limited exanthematous pustulosis in the setting of disseminated HSV. This case may represent the first report of AGEP and HSV overlap. It also presents the interesting dilemma of differentiating AGEP and disseminated HSV (which can present similarly) as well as determining appropriate treatment and the utility versus risk of systemic steroid administration.

  • Dermatology
  • Skin
  • Infectious diseases
  • Immunology
  • Infections

https://doi.org/10.1136/bcr-2024-260873

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    Footnotes

    • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: RLZ, BVS, PL and RW. The following authors gave final approval of the manuscript: RLZ, BVS, PL and RW.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.