A Case of Acute Generalised Exanthematous Pustulosis after Unprotected Sexual Intercourse on Holidays in Bali

Abstract

We present the case of a 43-year-old man with a clinical diagnosis of acute generalised exanthematous pustulosis in the setting of a recent 9-day holiday to Bali, Indonesia, to visit a female partner whom he had visited five times this year for unprotected sexual intercourse and from whom he had contracted a sexually transmitted infection. He also reports having taken some Indonesian cold and flu medications and ibuprofen.

Acute generalized exanthematous pustulosis caused by ibuprofen—Diagnosis confirmed by patch testing

“…Well‐known triggers of AGEP include antibiotic drugs such as β‐lactams, clindamycin, and macrolides. Ibuprofen has only very rarely been described as a cause of AGEP . This is the first case report in which the diagnosis of AGEP caused by ibuprofen has been confirmed by positive patch test results, suggesting a type IV T cell‐mediated pathogenesis.…”

“…This is the first case report in which the diagnosis of AGEP caused by ibuprofen has been confirmed by positive patch test results, suggesting a type IV T cell‐mediated pathogenesis. In the published case reports, the diagnosis was made clinically, histologically, or on the basis of a basophil activation test . The authors claimed that patch testing may trigger the original rash, but we found only a localized rash and pustulosis in the area of direct contact with ibuprofen.…”

“…In the published case reports, the diagnosis was made clinically, histologically, or on the basis of a basophil activation test. [2][3][4][5][6] The authors claimed that patch testing may trigger the original rash, but we found only a localized rash and pustulosis in the area of direct contact with ibuprofen. This is in line with a case series of 45 AGEP cases, in which a high percentage (50%-58%) of positive patch test findings and only 1 minor relapse after patch testing were described.…”