Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA
Dermatology, University of Maryland, Baltimore, Maryland, USA.
BMJ Case Rep. 2024 Aug 30;17(8):e260873. doi: 10.1136/bcr-2024-260873.
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.
急性泛发性发疹性脓疱病（AGEP）是一种罕见的皮肤疾病，表现为在水肿性红斑的背景上出现大量非毛囊性、针尖状无菌脓疱，可融合导致脱屑。90%的病例是由药物引起的，最常见的罪魁祸首是抗生素。然而，也有其他触发因素包括病毒感染的报道。单纯疱疹病毒（HSV）作为一种病毒触发因素尚未被探索。在这里，我们报告了一例由安非他酮引起的 AGEP，随后在播散性 HSV 背景下出现了第二次假定的急性局限性发疹性脓疱病。该病例可能代表 AGEP 和 HSV 重叠的首例报告。它还提出了一个有趣的困境，即区分 AGEP 和播散性 HSV（它们的表现相似），以及确定适当的治疗方法以及全身类固醇给药的效用与风险。
