{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:50Z","timestamp":1756339490236,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,21]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2024-260873","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T12:07:23Z","timestamp":1725019643000},"page":"e260873","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Acute generalised exanthematous pustulosis and herpes simplex virus: a case of possible overlap"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4502-7517","authenticated-orcid":false,"given":"Rachel Leigh","family":"Zachian","sequence":"first","affiliation":[{"name":"Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA"},{"name":"Dermatology, University of Maryland, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernita V","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Liu","sequence":"additional","affiliation":[{"name":"Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rina","family":"Weimann","sequence":"additional","affiliation":[{"name":"Main Line Health System, King of Prussia, Pennsylvania, USA"},{"name":"Schweiger Dermatology Group, King of Prussia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,30]]},"reference":[{"key":"2025082707535823000_17.8.e260873.1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s40257-023-00779-3","article-title":"Acute Generalized Exanthematous Pustulosis: Clinical Features, Differential Diagnosis, and Management","volume":"24","author":"Parisi","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"2025082707535823000_17.8.e260873.2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/ijd.IJD_581_17","article-title":"Acute Generalised Exanthematous Pustulosis: An Update","volume":"63","author":"De","year":"2018","journal-title":"Indian J Dermatol"},{"key":"2025082707535823000_17.8.e260873.3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.dsi.2013.12.004","article-title":"Acute generalized exanthematous pustulosis: A retrospective study of 51 cases in Taiwan","volume":"32","author":"Lee","year":"2014","journal-title":"Dermatol Sinica"},{"key":"2025082707535823000_17.8.e260873.4","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jdcr.2017.08.001","article-title":"Acute generalized exanthematous pustulosis simulating Stevens-Johnson syndrome\/toxic epidermal necrolysis associated with the use of vismodegib","volume":"4","author":"Moreno-Arrones","year":"2018","journal-title":"JAAD Case Rep"},{"key":"2025082707535823000_17.8.e260873.5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jdcr.2021.07.018","article-title":"Severe acute generalized exanthematous pustulosis with toxic epidermal necrolysis-like desquamation: A case series of 8 patients","volume":"15","author":"Huang","year":"2021","journal-title":"JAAD Case Rep"},{"key":"2025082707535823000_17.8.e260873.6","doi-asserted-by":"crossref","first-page":"9880827","DOI":"10.1155\/2022\/9880827","article-title":"Acute Generalized Exanthematous Pustulosis following SARS-CoV-2 Virus: Remdesivir as a Suspected Culprit","volume":"2022","author":"Mohaghegh","year":"2022","journal-title":"Case Rep Med"},{"key":"2025082707535823000_17.8.e260873.7","first-page":"421765","article-title":"An Uncommon Side Effect of Bupropion: A Case of Acute Generalized Exanthematous Pustulosis","volume":"2015","author":"Tak","year":"2015","journal-title":"Case Rep Dermatol Med"},{"key":"2025082707535823000_17.8.e260873.8","doi-asserted-by":"crossref","DOI":"10.1592\/phco.31.6.621","article-title":"Bupropion\u2010Induced Acute Generalized Exanthematous Pustulosis","volume":"31","author":"Ray","year":"2011","journal-title":"Pharmacotherapy"},{"key":"2025082707535823000_17.8.e260873.9","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1159\/000249246","article-title":"Acute generalized exanthematous pustular dermatitis and viral infection","volume":"173","author":"Rouchouse","year":"1986","journal-title":"Dermatologica"},{"key":"2025082707535823000_17.8.e260873.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jdin.2020.12.004","article-title":"Acute generalized exanthematous pustulosis: Epidemiology, clinical course, and treatment outcomes of patients treated in an Asian academic medical center","volume":"3","author":"Oh","year":"2021","journal-title":"JAAD Int"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:54:09Z","timestamp":1756306449000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":10,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,30]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bcr-2024-260873"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260873","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}