Acute Generalized Exanthematous Pustulosis Associated With Herpes Simplex Virus Reactivation Due to Cold Medicine: A Case Report and Review of the Literature

Acute generalized exanthematous pustulosis (AGEP) is a severe skin inflammation characterized by the sudden onset of numerous sterile, non-follicular pustules on an erythematous and edematous background, usually associated with fever. AGEP is commonly triggered by medications such as antibiotics. However, an association between AGEP and viral infections has also been reported recently. We report a case of a 70-year-old man who developed AGEP following the intake of an over-the-counter cold medicine in the context of herpes simplex virus (HSV) reactivation. Furthermore, we review three cases of AGEP associated with HSV infection. This report suggests HSV reactivation as a potential trigger for AGEP, emphasizing the need for caution when administering drugs to patients with HSV infection.