Abstract:
Coronavirus disease-19 (COVID-19) is an emerging global pandemic caused by “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2). Since its emergence, COVID-19-associated cutaneous manifestations have been increasingly reported, and are extremely polymorphic. Acute generalized exanthematous pustulosis (AGEP) is a rare exanthem characterized by the abrupt onset of numerous small non-follicular, sterile pustules arising on an erythematous base. Here, we report a case of acute generalized exanthematous pustulosis (AGEP) in a Tunisian adult a, few days after recovery from severe COVID-19. The direct and indirect role, of SARS-CoV-2 in the pathogenesis of this eruption is still debated and has not yet been established.
Introduction :
The novel coronavirus (SARS-CoV-2), the cause of the 2019 coronavirus disease (COVID-19), is rapidly spreading worldwide [1]. COVID-19 emerged in Tunisia in March 2020. Several cutaneous manifestations have been reported in association with COVID-19, such as urticaria, erythematous papular and/or vesicular rash, chilblains, livedo or purpura, and pustular eruptions such as acute generalized exanthematous pustulosis (AGEP) [2].
AGEP is a rare skin disease characterized by sudden skin eruption of numerous pinpoint, non-follicular, sterile pustules arising on an erythematous base. AGEP is mainly caused by drugs, especially antibiotics, such as amino-penicillins (beta-lactams) or macrolides [3]. Other etiologic agents have been reported to trigger AGEP such as spider bite, mercury and viral agents including coxsackie virus, cytomegalovirus (CMV), enterovirus, Epstein-Barr virus (EBV), hepatitis B virus, and parvovirus B19 (Parvo 19) [3].
To the best of our knowledge, only a few cases of AGEP related to COVID-19 have been reported [4-14].