Introduction

A male in early adolescence born to non-consanguineous parents was brought to dermatology outpatient department services with multiple pustular lesions over penis since 2 days. There was fever associated with chills and rigours. The patient is a known case of Lennox-Gastaut syndrome (multiple seizure types, electroencephalogram changes, intellectual impairment) on sodium valproate since 10 years. The patient was started on tablet lamotrigine 50 mg once daily in addition to sodium valproate 4 days prior to the lesions for the new onset of seizure episode. There was no history of irritant application. On cutaneous examination, there were multiple grouped non-follicular pustules on prepuce, shaft of penis with erythematous and oedematous background, at places coalescing to form lakes of pus (figure 1). Tzanck smear was negative …