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Acute Localized Exanthematous Pustulosis After Face and Neck Rhytidectomy: A Case of Locus Minoris Resistentiae
Liliana Fort1, Lucia Seminario-Vidal2, Amber N Pepper3
1From the Shorecrest Preparatory School, St. Petersburg, FL.
Plastic and Reconstructive Surgery. Global Open
|August 11, 2025
Summary
A rare drug reaction, acute localized exanthematous pustulosis, occurred in a woman after cefazolin. The rash appeared in surgical areas and resolved with corticosteroids.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Acute localized exanthematous pustulosis (ALEP) is a rare cutaneous drug eruption.
- Antibiotics, particularly cephalosporins like cefazolin, are common triggers.
Observation:
- A 52-year-old woman developed ALEP on her face and neck post-surgery.
- The rash localized to the surgical site, indicating a locus minoris resistentiae.
- The patient had received cefazolin for surgical prophylaxis.
Findings:
- Cefazolin administration precipitated ALEP in the surgical wound area.
- The localized nature of the rash supports the locus minoris resistentiae phenomenon.
- Topical corticosteroids led to the resolution of the pustular eruption.
Implications:
- This case highlights cefazolin as a potential cause of ALEP.
- The locus minoris resistentiae phenomenon is relevant in understanding localized drug reactions.
- Awareness of ALEP and its management is crucial for clinicians treating surgical patients.
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