Author Affiliations: Departments of Dermatology (Drs Loh, Fung, and Maverakis) and Pathology (Dr Fung), University of California, Davis, Sacramento; Department of Veterans Affairs, Mather, California (Dr Maverakis).
A 15-year-old girl presented with a 5-week history of pruritic erythematous guttate scaly papules on her abdomen and back (Figure 1). Three weeks beforehand, the patient began having a sore throat, swollen tonsils, fever, congestion, malaise, and fatigue. These symptoms worsened despite a course of azithromycin. A rapid streptococcus test finding was negative, but a heterophile assay result was positive. An Epstein-Barr virus (EBV) antibody profile showed the following findings: positive IgG to early D antigen, positive IgG and IgM to viral capsid antigen, and negative IgG to nuclear antigen, compatible with a recent EBV infection. An antistreptolysin O titer finding was negative.
Loh E, Fung MA, Maverakis E. Acute Guttate Psoriasis in a 15-Year-Old Girl With Epstein-Barr Virus Infection. Arch Dermatol. 2012;148(5):658-659. doi:10.1001/archdermatol.2011.3517