The acute onset of erythema and small pustules about the lower mouth. They resolved within a week.

ACUTE LOCALIZED EXANTHEMATOUS PUSTULOSIS

Acute localized exanthematous pustulosis (ALEP) is a rare and localized variant of acute generalized exanthematous pustulosis. At least 21 cases of ALEP had been reported in the literature; 15 cases were related to drug administration, and 6 pediatric cases occurred in springtime, with no associated drug administration in any case.

Clinical

There is the acute onset of monomorphous, non-follicular, white pustules on an erythematous base in a localized area, most commonly the face and particularly periorally. Fever and neutrophilia may occur. Antibiotics, especially β-lactams and macrolides, have been implicated in the majority of cases drugs but quinolones, hydroxychloroquine, sulfonamides, terbinafine, ibuprofen and diltiazem have been implicated. On average, the onset of lesions varies from as early as 24 hours after therapy initiation, to 1 to 2 weeks following treatment.

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