Mosquito Bite as a Potential Novel Trigger for Acute Generalized Exanthematous Pustulosis (AGEP): A Case Report

TL;DR

A 51-year-old woman developed a severe skin reaction resembling AGEP after a mosquito bite, suggesting insect bites may be a rare trigger.

Contribution

This case report introduces mosquito bites as a potential novel trigger for AGEP, expanding the known causes of this skin condition.

Findings

A patient developed AGEP-like symptoms after a mosquito bite with no evidence of medications or viral infections.

Histopathological analysis confirmed AGEP diagnosis despite atypical trigger.

Treatment with corticosteroids led to rapid improvement, supporting the clinical relevance of the case.

Abstract

Acute generalized exanthematous pustulosis (AGEP) is a rare and severe cutaneous adverse reaction characterized by the rapid onset of widespread sterile pustules on an erythematous base. While typically triggered by medications, AGEP has been associated with various agents, including viral infections and insect bites. We present the case of a 51-year-old woman who developed a diffuse pruritic papulopustular and vesicular rash following a mosquito bite. Despite negative tests for viral infections and medication use, histopathological analysis revealed classic features of AGEP. Treatment with systemic corticosteroids led to rapid symptom improvement. This case highlights the importance of considering uncommon triggers, such as mosquito bites, in the evaluation of pustular eruptions. It underscores the need for clinicians to maintain a broad differential diagnosis and consider unusual etiologies when evaluating patients with AGEP-like presentations, particularly in cases lacking typical inciting factors. Further research is necessary to explore the potential association between mosquito bites and AGEP and to elucidate the underlying pathophysiological mechanisms involved.

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