Acute generalised exanthematous pustulosis and herpes simplex virus: a case of possible overlap.

Rachel Leigh Zachian, Bernita V Sidhu, Phillip Liu, Rina Weimann

BMJ case reports 2024 Aug 30

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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. © BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Rachel Leigh Zachian, Bernita V Sidhu, Phillip Liu, Rina Weimann. Acute generalised exanthematous pustulosis and herpes simplex virus: a case of possible overlap. BMJ case reports. 2024 Aug 30;17(8)