Eosinophilic pustular folliculitis causes are unknown. Aug 21, 2012 eosinophilic pustular folliculitis epf, also known as ofuji disease, is a disease that manifests with follicular papules or pustules. Skin biopsies show eosinophils around hair follicles. They look very similar to normal pimples, hence in the initial stage they are usually left unnoticed. In eosinophilic pustular folliculitis, there is eosinophilic spongiosis and pustulosis involving the infundibular region of the hair follicle. There can be minimal numbers of neutrophils or mononuclear cells within the infiltrate. Dec 05, 2016 eosinophilic pustular folliculitis epf is a skin disorder characterized by recurring itchy, red or skincolored bumps and pustules bumps containing pus. Bacterial and fungal cultures of pustules were negative.
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. First described in japan by ofuji in 1970 1, eosinophilic pustular folliculitis epf is a noninfectious inflammatory skin disease that manifests with coalescing papulopustular plaques. Hivassociated eosinophilic folliculitis is usually extremely pruritic and may be managed with topical and systemic corticosteroids, and oral sedating antihistamines. Abstract eosinophilic pustular folliculitis is a rare condition characterized by recurrent, pruritic peripherally expanding, sterile papulopustules and plaques. Plike lesions occurring concurrently with eosinophilic pustular folliculitis is high. The disease is histologically characterized by eosinophilic infiltration of hair follicles. Although the histopathologic feature of eosinophili. A clinically distinct form of ef ofujis disease has also been described in. It must be distinguished from other causes of a pustular eruption in neonates, including infection and erythema toxicum neonatorum, and rare disorders such as transient neonatal pustular. Eosinophilic pustular folliculitis is a cutaneous disorder that consists of recurrent crops of pruritic, sterile, papulopustules in a follicular distribution. Chemical irritation of the skin less commonly eg, from oily overalls. Rashes caused by this skin disorder can be observed in the upper part of the body like the scalp, face, neck, trunk, chest, etc.
Eosinophilic pustular folliculitis american academy of. Also called eosinophilic pustular folliculitis or eosinophilia, this rash is very itchy and commonly found on the upper region of the body. Eosinophilic folliculitis is a skin disease, primarily characterized by skin rash, itchiness and frequent recurrences. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed eosinophilic pustular folliculitis symptoms. Eosinophilic folliculitis is generally observed in young adult males. Although the histopathologic feature of eosinophilic pustular folliculitis is characterized by follicular infiltrates with numerous eosinophils, its. As a clinical term, eosinophilic folliculitis corresponds to a trio of uncommon to rare but distinctive disorders characterized by the histopathologic least common denominator of folliculitis with numerous eosinophils. The lesions are characterized by pruritic follicular papulopustules with a predilection for seborrheic areas. We report a new case of eosinophilic pustular folliculitis in a 23month. Eosinophilic folliculitis an overview sciencedirect topics. This medical condition is also known as eosinophilic pustular folliculitis, sterile eosinophilic pustulosis or ofuji disease.
Although the histopathologic feature of eosinophilic pustular folliculitis is characterized by follicular infiltrates with numerous eosinophils, its pathophysiology remains unclear. Classic epf, which occurs mainly in adults, is generally chronic and recurrent but benign. In the classic form of eosinophilic pustular folliculitis, mild to. A collection of disease information resources and questions answered by our genetic and rare diseases information specialists for eosinophilic pustular. Hairbearing areas such as the face, chest, back, and extensor surfaces of the upper arms are usually involved, although palms and soles can be affected as well. Eosinophilic pustular folliculitis eosinophilic pustular folliculitis cutler, t. Evaluation of the effectiveness of antibiotics against eosinophilic pustular folliculitis article pdf available in case reports in dermatology 52.
Epfi is related to adult eosinophilic pustular folliculitis epf, also known as ofuji disease, and immunosuppressionassociated epf. Sterile eosinophilic pustulosis medication list about eosinophilic folliculitis. Pdf we report a case of a 27yearold man with characteristic features of sterile eosinophilic folliculitis type ofuji. Diagnosis of ef in association with hematologic malignancy can be challenging owing to variable morphologies and.
Eosinophilic folliculitis is a noninfectious, recurrent skin condition that presents with itchy papules or pustules that look like acne or other forms of folliculitis. The classic variant, eosinophilic pustular folliculitis ofuji, is more. 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. Over the past 2 decades, the spectrum of eosinophilic folliculitis has expanded to pediatric populations, transplant recipients, and persons with hiv and hematopoietic disorders. Case report eosinophilic pustular folliculitis of ofuji in an. The name of the disease comes from the eosinophils, which. The condition is named after the fact that skin biopsies of this disorder find eosinophils a type of immune cell around hair follicles.
Neonatal eosinophilic pustular folliculitis buckley. Ofujis eosinophilic pustular folliculitis is usually less pruritic. Mar 26, 2019 other names have also been proposed eg, classic form of eosinophilic folliculitis, ofuji disease, eosinophilic pustular dermatosis. A published workbased comprehensive analysis of therapeutic responsiveness.
Eosinophilic pustular folliculitis ofujis disease jama network. Eosinophilic pustular folliculitis genetic and rare diseases nih. The papules mostly appear on the face, scalp, neck and trunk and may persist for weeks or months. Eosinophilic folliculitis is a serious condition that affects the hair follicles and causes a painful rash. However, a fungal cause is suggested by 1 tinealike annular lesions, 2 initial clinical. Eosinophilic pustular folliculitis genetic and rare. Dec 05, 2016 the longterm outlook prognosis for people with eosinophilic pustular folliculitis epf depends on the type of epf present classic, infantile, or immunosuppressionassociated. We present a case of eosinophilic pustular folliculitis, a rare dermatosis which is often associated with hiv. These eruptions often are associated with peripheral blood eosinophilia and occur mainly on the face, upper back, and upper extremities. An aggressive case of granulomatous eosinophilic pustular. Ef is a relatively common skin eruption in patients with advanced human immunodeficiency virus hiv disease. Eosinophilic folliculitis pictures, symptoms, diagnosis. Individual lesions typically last more than 12 weeks, and relapse every 34 weeks.
Furthermore, signs and symptoms of eosinophilic pustular folliculitis may vary on an individual basis for each patient. Generalized eosinophilic pustular folliculitis of infancy responding to hydroxyzine. Eosinophilic pustular folliculitis pathology dermnet nz. If left untreated, dark scarring can be left when the rash heals, which may or may not disappear over time. In pediatric patients, epf presents primarily in the scalp and is confused with several other more common dermatoses in children. Eosinophilic folliculitis definition of eosinophilic.
A 29yearold hivnegative man presented with a 1year history of a widespread pruritic eruption. Many patients have either absolute or relative peripheral eosinophilia. Five years later, and after 3 additional cases, ofuji named this skin condition eosinophilic pustular folliculitis epf. Indomethacin as a first choice of treatment, abstract eosinophilic pustular folliculitis epf is characterized by erythematous patches of large follicular papules and pustules involving mainly the face.
Pdf evaluation of the effectiveness of antibiotics against. Neonatal eosinophilic pustular folliculitis buckley 2001. Pdf generalized eosinophilic pustular folliculitis of infancy. Eosinophilic pustular folliculitis in patients with acquired immunodeficiency syndrome. Diagnosis of ef in association with hematologic malignancy can be challenging owing to. If left untreated, dark scarring can be left when the rash heals, which may or may not disappear. Eosinophilic pustular folliculitis epf is a rare, chronic, relapsing dermatosis predominantly seen in east asians that was first described in 1970 by ofuji. Eosinophilic pustular folliculitis is a rare condition characterized by recurrent, peripherally expanding, sterile papulopustules and plaques. Eosinophilic pustular folliculitis epf is a sterile inflammatory dermatosis of unknown etiology. Nomura t12, katoh m1, yamamoto y1, miyachi y, kabashima k1. The lesions usually form on the head, neck, and shoulder. The peak incidence occurs in the third decade of life and its exact etiology. The lesions initially begin as discrete papules and pustules on the face, back, and extensor surfaces of the arms. Eosinophilic folliculitis ef is a recurrent skin disorder of unknown etiology.
Hair bearing areas such as face, chest, back and extensor surfaces of the upper arms are usually involved. Pmid 1568818 metronidazole for eosinophilic pustular folliculitis in human immunodeficiency virus type 1positive patients. Variants of eosinophilic folliculitis include classic type, hiv related, infantile, and cancer associated. Eosinophilic pustular folliculitis epf is a rare dermatosis characterized by recurrent outbreaks of papulopustular skin lesions mainly distributed in seborrheic areas. Eosinophilic pustular folliculitis epf or ofuji disease is a rare dermatosis, prone to recurrence and chronicity. Symptomatic zinc deficiency in infants can be explained on the basis of malabsorption. We describe nine patients with eosinophilic pustular folliculitis occurring in infancy. In addition to classic epf, which affects otherwise healthy individuals, an immunocompromised state can cause immunosuppressionassociated epf isepf, which may be referred to dermatologists in inpatient services for assessments. The classic variant, eosinophilic pustular folliculitis ofuji, is more common in japan. Eosinophilic pustular folliculitis epf is a noninfectious disease characterized by the histologic features of a predominant infiltration by eosinophils in and around hair follicles. Ef consists of itchy red bumps centered on hair follicles and. Eosinophilic folliculitis ef is an itchy rash with an unknown cause which is most common among individuals with hiv, though it can occur in normal individuals where it is known by the eponym ofuji disease. Biopsy specimens revealed folliculitis with a predominant eosinophilic infiltrate.
Physical irritation eg, traction folliculitis as a result of a hairstyle. Eosinophilic pustular folliculitis induced by allopurinol and timepidium bromide. Skin inflammatory nontumor eosinophilic pustular folliculitis. Eosinophilic folliculitis a rare autoimmune disease, more common in asian races. Physical examination revealed clusters of erythematous follicular papules and. In 1965, ise and ofuji reported a case of recurrent follicular pustules and eosinophilia in a japanese woman. The first case of epf was described by ise and ofuji1 in 1965 in. Typically, small papules enlarge and coalesce into large plaques, usually on the face. The condition may occur anywhere on the skin except the palms of the hands and soles of the feet. Ef consists of itchy red bumps papules centered on hair follicles and typically found on the upper body, sparing the abdomen and legs. 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. Association with longterm immunosuppressant use in a solid organ transplant recipient. Eosinophilic pustular folliculitis epf of infancy is a rare disorder which may begin in the neonatal period and cause considerable parental anxiety.
All patients had recurrent crops of pruritic papules primarily affecting the scalp and brow region of the face. Eosinophilic folliculitis ef is a rare, recurrent dermatosis characterized by folliculocentric papules, pustules, or plaques affecting the head, trunk, and extremities. Cutler department of dermatology, university college hospital, gower street, london wcie 6au accepted for publication 12 june 1980 history mr w. Physical examination revealed clusters of erythematous follicular papules and pustules primarily on. The papules mostly appear on the face, scalp, neck and trunk and may persist for.
Mar 30, 2020 eosinophilic pustular folliculitis is more common in men than in women, although a survey confirmed these data for all but classic eosinophilic pustular folliculitis cases, in which the incidence was the same in both sexes. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Widespread eosinophilic pustular folliculitis in a. Many other agents, including phototherapy, have been reported to be effective. These lesions eventually coalesce to form circinate plaques composed of a peripheral rim of pustules and central clearing within the. Eosinophilic pustular folliculitis is a distinctive dermatosis that was first described in japan. Pdf evaluation of the effectiveness of antibiotics. Folliculitis is the infection and inflammation of one or more hair follicles. Eosinophilic pustular folliculitis in infancy and childhood. Pdf eosinophilic pustular folliculitis induced by allopurinol and.
Eosinophilic folliculitis in a patient with chronic. 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. Our patient was a case of classic eosinophilic pustular folliculitis, as he was hiv negative and peripheral eosinophil count was 33%. Definition background information eosinophilic folliculitis is an uncommon and benign skin condition that is characterized by the presence of skin rashes with acnelike appearance. Eosinophilic pustular folliculitis epf, also known as ofuji disease, is a disease that manifests with follicular papules or pustules. Eosinophilic pustular folliculitis epf is a skin disorder characterized by recurring itchy, red or skincolored bumps and pustules bumps containing pus. Its variants include a classic type that occurs most commonly in japan, an hivassociated type, an infantile type, a type that occurs on the palms and soles, a rare medicationassociated variant, and a rare neoplasiaassociated variant. Most lesions are located on the scalp and distal extremities. Therapeutic effectiveness of various treatments for eosinophilic. The diagnosis of epf rests on its inclusion in the differential diagnosis of papulopustular disorders, the. The rash may appear as pimples that come to white tips on the face, chest, back, arms, legs, buttocks, or head.
Abstract eosinophilic pustular folliculitis is a cutaneous disorder that consists of recurrent crops of pruritic, sterile, papulopustules in a follicular distribution. Eosinophilic pustular folliculitis is a rare condition with no known cause. Oral cyclosporine was markedly effective in all 11 patients treated, and topical tacrolimus ointment alleviated eosinophilic pustular folliculitis in 3 of 7 with one. Pathology outlines eosinophilic pustular folliculitis. Eosinophilic pustular folliculitis with underlying mantle. Ef consists of itchy red bumps centered on hair follicles and typically found on the upper body, sparing the abdomen and legs. The follicle mite, demodex, has also been considered a possible triggering agent. Eosinophilic pustular folliculitis of infancy epfi is a pruritic dermatosis characterized by scalp pustules. Eosinophilic pustular folliculitis epf is a noninfectious condition characterized by folliculocentric papules, pustules, and plaques on the head, trunk, and extremities. Eosinophilic pustular folliculitis saruta 1980 the. Histopathology predominantly shows abundant eosinophils concentrated at the follicle, and treatment typically consists of topical corticosteroids or oral indomethacin. In certain patients, a combination of pityrosporum species and demodex species might play a role in the pathogenesis of the disease. The diagnosis of epf rests on its inclusion in the differential diagnosis of papulo pustular disorders, the. Eosinophilic pustular folliculitis american academy of pediatrics.
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