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Eosinophilic pustular folliculitis

What is it eosinophilic pustular folliculitis?

Eosinophilic pustular folliculitis is a recurrent skin disorder of unknown cause. It is also known as eosinophilic folliculitis and Ofuji disease. Fur biopsies of this disorder find eosinophils around hair follicles - Hence its name.

There are several variants of eosinophilic pustular folliculitis. They all have itching papules or pustules. Eosinophilic pustular folliculitis is rare and affects men more frequently than women. Variants include:

  • Classic type eosinophilic pustular folliculitis: This occurs most frequently in Japan
  • Eosinophilic folliculitis associated with advanced human immunodeficiency virus (HIV) infection
  • Infantile eosinophilic pustular folliculitis
  • CancerDisease-associated eosinophilic pustular folliculitis
  • Drug-associated eosinophilic pustular folliculitis.

What is eosinophilic pustular folliculitis like?

Eosinophilic pustular folliculitis presents with itchy, red or skin-colored dome-shaped papules and pustules. It may look like acne or other forms of folliculitis. Papules appear primarily on the face, scalp, neck, and trunk and may persist for weeks or months. Less commonly, urticarial lesions are seen (these are larger red irritants bump-like patches similar to urticaria) The palms and soles of the feet may rarely develop similar papules and pustules, but in such cases the condition should not be called folliculitis, since there are no follicles in these areas.

Long-standing cases may develop. dermatitis or a form of prurigo, presumably from itching and scratching.

HIV eosinophilic folliculitis


Eosinophilic folliculitis


Eosinophilic folliculitis


Eosinophilic folliculitis

How is eosinophilic folliculitis diagnosed?

Skin biopsy reveals eosinophils beneath the skin's surface and around hair follicles and sebaceous glands (see eosinophilic folliculitis) pathology) In many cases, blood tests show a slight increase in eosinophils cells and immunoglobulin-E (IgE), and reduced levels of IgG and IgA.

Eosinophilic pustular folliculitis is often a feature of immunodeficiency. Eosinophilic pustular folliculitis associated with HIV infection occurs when CD4 levels lymphocyte cells drop below 300 cells/mm3, a level at which there is an increased risk of secondary opportunistic infection. Cases of eosinophilic pustular folliculitis after bone marrow have also been reported. transplant before the immune system returns to normal functioning and in some individuals with hereditary immune deficiencies.

What is the cause of HIV eosinophilic pustular folliculitis?

The cause of HIV eosinophilic pustular folliculitis is not known. Immunodeficiency appears to lead to an increased risk of allergic-type skin diseases. There is no proof that bacterial, secondary fungal or viral infection is the cause, although some researchers have postulated overgrowth of Malassezia or Demodex (the hair follicle Pinch) could be involved. Another theory is that there is a change in the immune system that causes eosinophils to attack tallow produced by the cells of the sebaceous glands.

What is the treatment for eosinophilic pustular folliculitis?

In patients with HIV, eosinophilic pustular folliculitis is likely to improve or resolve with HAART (highly active antiretroviral therapy) as CD4 cell counts increase above 250/mm3.

Other treatments that may be effective include:

  • Indomethacin and other non-steroidal anti-steroidsinflammatory The drugs are reported to be effective in up to 70% cases of eosinophilic folliculitis
  • Dapsone
  • Tetracycline antibiotics
  • Other antibiotics, including metronidazole
  • Phototherapy
  • Current steroids
  • Calcineurin inhibitors such as tacrolimus ointment

  • Oral antihistamines such as cetirizine.

  • Colchicine
  • Itraconazole
  • Permethrin cream (topical insecticide)
  • Nicotine patches
  • Isotretinoin and acitretin.

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