Eosinophilic pustular folliculitis in infancy, infantile eosinophilic pustular folliculitis, and neonatal eosinophilic pustular folliculitis specialty. An aberrant helper tcell type 2 immune response to a follicular antigen, such as demodex, might be involved in the pathogenesis of hivassociated eosinophilic pustular folliculitis. Picture of eosinophilic pustular folliculitis children with this rare disorder develop repeated crops of pruritic erythematous papules, yellow or white pustules, which vary in size from 1 to 3 mm. Eosinophilic pustular folliculitis of infancy annals of clinical case. Eosinophilic pustular folliculitis american academy of pediatrics. Most lesions are located on the scalp and distal extremities. What are the differential diagnoses for eosinophilic. This noninfectious eosinophilic infiltration of hair follicles predominantly seen in the japanese population. Eosinophilic folliculitis is noninfectious and of unclear etiology. Eosinophilic pustular folliculitis was first described in a japanese female presenting with folliculocentric pustules distributed on the face, torso, and arms.
Extensive local excision and placement of a free skin graft was performed in. Folliculitis is an inflammatory process involving any part of the hair follicle. Skin biopsies show eosinophils around hair follicles. Based on these findings, a diagnosis of eosinophilic pustular folliculitis epf was. Eosinophilic pustular folliculitis may also be associated with human immunodeficiency virus infection, various drugs, and some lymphomas and could also be thought of as a nonspecific dermatopathologic pattern in such settings. Mazuecos blanca and others published eosinophilic pustular folliculitis ofujis disease. Eosinophilic folliculitis ef is a pruritic skin eruption consisting of follicular papules or pustules, predominantly located on the scalp, face, neck, and upper chest picture 1ab.
Eosinophilic pustular folliculitis in infancy and childhood jama. Eosinophilic pustular folliculitis with underlying mantle. Although described in healthy individuals, it has been increasingly recognized in those infected with hiv 74 and less commonly in hivnegative patients being treated for. Skin biopsies of this disorder find eosinophils around hair follicles hence its name there are several variants of eosinophilic pustular folliculitis. Ulrike blumepeytavi, md, department of dermatology, university medical center benjamin franklin, the free university of berlin. It is known to occur and persist in immunosuppressed patients.
Eosinophilic pustular folliculitis american academy of. All patients had recurrent crops of pruritic papules primarily affecting the scalp and brow region of the face. The longterm outlook prognosis for people with eosinophilic pustular folliculitis epf depends on the type of epf present classic, infantile, or immunosuppressionassociated. Eosinophilic pustular folliculitis epf, also known as ofuji disease, is a rare, idiopathic, inflammatory skin disease. Diagnosis is made by anamnesis, clinical symptoms as well as by changes in histopathology.
We report a new case of eosinophilic pustular folliculitis in a 23month. The condition is named after the fact that skin biopsies of this disorder find eosinophils a type of immune cell around hair follicles. Eosinophilic pustular folliculitis epf of infancy is a rare disorder which may begin in the neonatal period and cause considerable parental anxiety. Amongjapanesemen, eosinophilic pustular folliculitis ofuji disease arises at an average age of 30 years. Neonatal eosinophilic pustular folliculitis buckley. Nishikawa, department of dermatology, keio university school of medicine, tokyo, japan. Eosinophilic pustular folliculitis epf is a dermatosis of unknown aetiology, characterized by repeated development of pruritic follicular papulopustules with a tendency to form an annular. Eosinophilic pustular folliculitis, sterile eosinophilic pustulosis specialty. Eosinophilic pustular folliculitis is a cutaneous disorder that consists of recurrent crops of pruritic, sterile. In pediatric patients, epf presents primarily in the scalp and is confused with several other more common dermatoses in children. A perifollicular inflammatory infiltrate containing numerous eosinophils is present hematoxylin and eosin.
Eosinophilic folliculitis pictures, symptoms, diagnosis. Ef is a relatively common skin eruption in patients with advanced human immunodeficiency virus hiv disease. Generalized eosinophilic pustular folliculitis of infancy responding to hydroxyzine. Eosinophilic pustular folliculitis eosinophilic pustulosis, eosinophilic pustular folliculitis ofuji. Eosinophilic pustular folliculitis ofujis disease jama network. Eosinophilic pustular folliculitis of infancy wikipedia. Original article eosinophilic pustular folliculitis.
Eosinophilic folliculitis definition of eosinophilic. Cutler department of dermatology, university college hospital, gower street, london wcie 6au accepted for publication 12 june 1980 history mr w. A proposal of diagnostic and therapeutic algorithms takashi nomura,1,2 mayumi katoh,1 yosuke yamamoto,1 yoshiki miyachi,1,3 kenji kabashima1 1department of dermatology, kyoto university graduate school of medicine, 2department of dermatology, ijinkai takeda general hospital, kyoto, 3shiga medical center for adults, shiga, japan. This medical condition is also known as eosinophilic pustular folliculitis, sterile eosinophilic pustulosis or ofuji disease. Abstract eosinophilic pustular folliculitis epf is a sterile inflammatory dermatosis of unknown etiology. Eosinophilic folliculitis wikimili, the free encyclopedia. The papules mostly appear on the face, scalp, neck and trunk and may persist for weeks or months. Eosinophilic folliculitis an overview sciencedirect topics. Bacterial and fungal cultures of pustules were negative. Eosinophilic pustular folliculitis epf is a noninfectious condition characterized by an eosinophilic infiltration of the hair follicles.
What does eosinophilic pustular folliculitis look like. Pdf on aug 1, 2015, joo hyun lee and others published generalized eosinophilic pustular folliculitis of infancy. Eosinophilic pustular folliculitis archives of pathology. First reported in 1986 by soeprono and schinella, 7 hivef was given its name to distinguish it from ofuji disease eosinophilic pustular folliculitis. We describe nine patients with eosinophilic pustular folliculitis occurring in infancy. What is eosinophilic pustular folliculitis eosinophilic pustular folliculitis is a recurrent skin disorder of unknown cause. Many other agents, including phototherapy, have been reported to be effective. In 1965, ise and ofuji reported a case of recurrent follicular pustules and eosinophilia in a japanese woman. Eosinophilic pustular folliculitis epf is a noninfectious disease characterized by the histologic features of a predominant infiltration by eosinophils in and around hair follicles. Inflammatory infiltrate an overview sciencedirect topics. Eosinophilic pustular folliculitis wiley online library.
A collection of disease information resources and questions answered by our genetic and rare diseases information specialists for eosinophilic pustular. The condition may occur anywhere on the skin except the palms of the hands and soles of the feet. Eosinophilic folliculitis is a noninfectious, recurrent skin condition that presents with itchy papules or pustules that look like acne or other forms of folliculitis. Hivassociated eosinophilic folliculitis is usually extremely pruritic and may be managed with topical and systemic corticosteroids, and oral sedating antihistamines. The disease has been reported in aids, and a possibly separate form of eosinophilic pustular folliculitis occurs in. Erika dagata, in mandell, douglas, and bennetts principles and practice of infectious diseases eighth edition, 2015. Eosinophilic pustular folliculitis epf is a skin disorder characterized by recurring itchy, red or skincolored bumps and pustules bumps containing pus. Pdf generalized eosinophilic pustular folliculitis of infancy. Classic epf, which occurs mainly in adults, is generally chronic and recurrent but benign. It is a recreational skin infection associated with immersion in contaminated swimming pools, hot tubs, and whirlpools. Eosinophilic pustular folliculitis is a cutaneous disorder that consists of recurrent crops of pruritic, sterile, papulopustules in a follicular distribution.
Skin biopsies of this disorder find eosinophils around hair follicles hence its name. Eosinophilic pustular folliculitis eosinophilic pustular folliculitis cutler, t. Eosinophilic pustular folliculitis genetic and rare diseases nih. Hivassociated eosinophilic folliculitis hivef was first reported in 1986 by soeprono and schinella, which is a variant of eosinophilic pustular folliculitis epf known as ofuji disease and characterized by pruritic. Pdf a 65 yearsold female caucasian patient, who had suffered for one. It is also known as eosinophilic folliculitis and ofuji disease.
In eosinophilic pustular folliculitis, there is eosinophilic spongiosis and pustulosis involving the infundibular region of the hair follicle. Eosinophilic folliculitis is an itchy rash with an unknown cause that is most common among individuals with hiv, though it can occur in hivnegative individuals where it is known by the eponym ofuji disease. Abstract eosinophilic pustular folliculitis epf is a sterile inflammatory. Some question whether it is merely an infantile variant of adult eosinophilic pustular folliculitis ofuji disease, but the course and clinical presentation differs, with involvement primarily of the scalp and brow. Widespread eosinophilic pustular folliculitis in a. Individual lesions typically last more than 12 weeks, and relapse every 34 weeks. In certain patients, a combination of pityrosporum species and demodex species might play a role in the pathogenesis of the disease.
Eosinophilic pustular folliculitis ofujis disease request pdf. Eosinophilic folliculitis ef is a recurrent skin disorder of unknown etiology. Eosinophilic pustular folliculitis is a dermatological condition, that involves the formation of pustules in the hair follicles, due to an infiltration of the latter by eosinophils, without the participation of bacteria. Unsuccessful prior treatments had included isotretinoin, fluocinonide gel, indomethacin, erythromycin, dicloxacillin, fluconazole, loratidine, cetirizine, doxepin, and ultraviolet b phototherapy. Eosinophilic pustular folliculitis is a distinctive dermatosis that was first described in japan. Pdf eosinophilic pustular folliculitis ofuji disease. It is important to recognize noninfectious causes of folliculitis e.
Variants of eosinophilic folliculitis include classic type, hiv related, infantile, and cancer associated. Eosinophilic folliculitis is a skin disease, primarily characterized by skin rash, itchiness and frequent recurrences. The rash may appear as pimples that come to white tips on the face, chest, back, arms, legs, buttocks, or head. Eosinophilic pustular folliculitis ofujis disease journal of the. Canine eosinophilic folliculitis and furunculosis is described in a fouryearold kromfohrlaender. Several chronically itchy papular and papulopustular eruptions variously referred to as ppe of hiv infection, itchy red bump disease, eosinophilic pustular folliculitis, eosinophilic folliculitis, papular urticaria, prurigo nodularis, insect bite reactions have been reported in hiv infected patients. This content is excerpted from mksap 17 with permission from the american college of physicians acp. Among these rare entities, eosinophilic pustular folliculitis may be associated with human immunodeficiency virus hiv infection or malignancies, and some other diseases, like eosinophilic fasciitis and eosinophilic cellulitis, may be associated with an underlying hematological disorder, while others are considered idiopathic.
Thalidomide in the treatment of sweets syndrome and. Alerts and notices synopsis eosinophilic pustular folliculitis in infancy epfi is a rare selflimited disorder of unknown cause. Eosinophilic pustular folliculitis associated with cutaneous. Wellrecognized variants of eosinophilic folliculitis ef, also known as eosinophilic pustular folliculitis, include ofuji disease, infantile ef, and hivassociated ef, which is considered a defining illness of aids a fourth less commonly recognized subtype of ef is that associated with hematologic malignancy, in particular leukemia and nonhodgkin lymphoma nhl. A case of eosinophilic pustular folliculitis with response to infliximab. Pdf a case of eosinophilic pustular folliculitis with. A 29yearold hivnegative man presented with a 1year history of a widespread pruritic eruption. Folliculitis symptoms, diagnosis and treatment bmj. Eosinophilic pustular folliculitis pathology dermnet nz.
Eosinophilic pustular folliculitis induced by carbamazepine. Physical examination revealed clusters of erythematous follicular papules and pustules primarily on. A patchy lesion on the cheek in a patient with eosinophilic pustular folliculitis. Pathergy in atypical eosinophilic pustular folliculitis. Eosinophilic pustular folliculitis saruta 1980 the. Eosinophilic pustular folliculitis genetic and rare. Hot tub folliculitis an overview sciencedirect topics. The follicle mite, demodex, has also been considered a possible triggering agent. Widespread eosinophilic pustular folliculitis in a nonimmunocompromised patient.
A clinically distinct form of ef ofujis disease has also been described in. Ef consists of itchy red bumps papules centered on hair follicles and typically found on t. The first case of epf was described by ise and ofuji1 in 1965 in. Hot tub folliculitis is an infection of the infundibulum upper segment of the hair follicle, just beneath the skin surface. Biopsy specimens revealed folliculitis with a predominant eosinophilic infiltrate. Eosinophilic folliculitis ef has been regarded as a significant marker of advanced aids, reportedly occurs in 910% hiv infected patients 2, 3.
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