Pustular eruption on the face revealing HIV infection

Imane Couissi, Hanane Baybay, Meryem Soughi, Zakia Douhi, Sara El Loudi, Fatima Zahra Mernissi

Department of Dermatology, University Hospital Hassan II Fès, Morocco

Corresponding author: Imane Couissi, MD, E-mail: imane.couissi@usmba.ac.ma

How to cite this article: Couissi I, Baybay H, Soughi M, Douhi Z, El Loudi S, Mernissi FZ. Pustular eruption on the face revealing HIV infection. Our Dermatol Online. 2024;15(e):e2.
Submission: 19.01.2023; Acceptance: 24.01.2024
DOI: 10.7241/ourd.ourd.2024e.2

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© Our Dermatology Online 2024. No commercial re-use. See rights and permissions. Published by Our Dermatology Online.

Numerous infections arise during the course of an HIV-positive person’s evolution, most often leading to AIDS disease. Most of them are said to be opportunistic and induced by severe immunodepression.

HIV-associated suppurative folliculitis is usually of bacterial origin [1]. When bacterial cultures are performed, Staphylococcus aureus is the most often organism implicated [2].

Bacterial folliculitis is common in HIV patients, whose immunity is still apparently normal but in fact, recognizes a qualitative deficit. However, they occur in almost one out of two AIDS patients in an advanced immunodepressive situation.

In a study of 40 HIV-positive patients, suppurative folliculitis was the cause of follicular eruptions in two-thirds of cases [3].

We report a case of suppurative folliculitis limited to the face revealing an HIV infection.

A 45-year-old divorced man who has just been released from prison, presented with a week’s history of pustular eruption on the face and a flu-like syndrome (fever, chills, and sore throat) one week prior. Clinical examination showed multiple confluent follicular and non-follicular pustules on the face, forehead, and lateral aspect of the neck on erythematous skin (Figs. 1a1d). Examination of the oral mucosa found pharyngitis.

Figures 1: (a-d) Clinical picture showing multiple confluent follicular and non-follicular pustules on the face, forehead, and lateral aspect of the neck.

HIV infection was suspected given the patient’s history, symptoms and was confirmed by serology. The patient was put on macrolide and a skin biopsy was planned but the pustular lesions have disappeared (Figs. 2a2d).

Figures 2: (a-d) Clinical picture showing the disappearance of the lesions after antibiotic treatment.


The examination of the patient was conducted according to the principles of the Declaration of Helsinki.


1. Gelfand JM, Rudikoff D. Evaluation and treatment of itching in HIV-infected patients. Mt Sinai J Med.2001;68:298–308.

2. Ekpe O, Forae GD, Okpala CI. Pruritic papular eruption of HIV:a review article. Our Dermatol Online. 2019;10:191-6.

3. Guzman AK, Pappas-Taffer LK, Elston DM, James WD. Acute and recurrent facial pustulosis:a unique clinical entity?J Eur Acad Dermatol Venereol. 2018 May;32:e193-e195.


Source of Support: This article has no funding source.

Conflict of Interest: The authors have no conflict of interest to declare.

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